Organization
AUDREY J BRUELL DERMATOLOGY
Active
Other names
AUDREY J BRUELL MD
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DURIN (OFFICE MANAGER)
(517) 505-0661
Entity
Organization
Contact information
Practice address
37605 PEMBROKE AVE, LIVONIA, MI 48152-1050
(734) 591-7931
(734) 464-0335
Mailing address
37605 PEMBROKE AVE, LIVONIA, MI 48152-1050
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
4301062941
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368769
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
08/22/2020
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