Individual
DR. BRIAN B BRUGGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 BALTIMORE DR, WILKES BARRE, PA 18702-7900
(570) 808-6400
(570) 808-6338
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9803
(570) 808-6400
(570) 808-6338
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD485999
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023267895
—
ID
05
—
1023267895
—
MT
05
—
1023267895
—
WY
05
—
1356344626
—
WI
01
—
18032746
STATE COMP FUND AZ
AZ
01
—
31346
STATE LICENSE AZ
AZ
05
—
784422
—
AZ
05
—
808217900
—
ID
01
—
8607474153011
TAX ID
AZ
01
—
8640234
CIGNA
AZ
01
—
AZ0734420
BLUE CROSS BLUE SHIELD AZ
AZ
05
—
P784422
—
AZ
01
—
POOOO4401
RAILROAD MEDICARE
AZ
Enumeration date
05/31/2005
Last updated
01/02/2026
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