Individual
DR. KATHERINE T BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
88 E NEWTON ST, EVANS 124, BOSTON, MA 02118-2308
(617) 638-6500
(617) 638-6501
Mailing address
LAHEY PROVIDER ENROLLMENT, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8085
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
262680
MA
207RG0100X
Gastroenterology Physician
Primary
262680
MA
Other
Enumeration date
05/14/2012
Last updated
07/12/2019
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