Individual
JOHN E BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 SIXTH ST STE 208, TRAVERSE CITY, MI 49684-2360
(231) 935-2045
(231) 935-3420
Mailing address
1221 SIXTH ST STE 208, TRAVERSE CITY, MI 49684-2360
(231) 935-2045
(231) 935-3420
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301044585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203481
ANTHEM
OH
01
—
00722
PARAMOUNT
OH
05
—
0735673
—
OH
01
—
100187
PHYSICIANS HEALTH COLLABERATIVE
OH
01
—
4095569
AETNA
OH
01
—
4340207(10)0
MICHIGAN MEDICAID
MI
01
—
460003221
MEDICARE RR
OH
01
—
600489
BUCKEYE
OH
Enumeration date
06/21/2005
Last updated
02/28/2023
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