Individual
DR. MATTHEW JUSTIN BRUNER
Active
Individual
DR. MATTHEW JUSTIN BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
05-34533
KS
207L00000X
Anesthesiology Physician
Primary
2005025705
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386798189
—
MO
05
—
200662760A
—
OK
05
—
216316003
—
AR
01
—
P01787086
RAIL ROAD MEDICARE
MO
Enumeration date
01/22/2007
Last updated
06/11/2019
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