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Individual

MICHAEL R BRUNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(307) 333-6910
(307) 333-6912
Mailing address
PO BOX 50770, CASPER, WY 82605-0770
(307) 333-6910
(307) 333-6912

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4186A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104863500
WY
01
305752
BLUE SHIELD
WY
01
82601D022
WPS TRIWEST
WY
01
930013243
RAILRAOD MEDICARE
WY
Enumeration date
07/26/2006
Last updated
04/11/2019
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