Individual
PAUL T BRUNGARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6406
(816) 271-7986
Mailing address
5301 FARAON ST STE 120, SAINT JOSEPH, MO 64506-3512
(816) 271-6406
(816) 271-7986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022034945
MO
208M00000X
Hospitalist Physician
Primary
2022034945
MO
Other
Enumeration date
04/10/2019
Last updated
10/09/2024
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