Individual
JOEL THOMAS BRUGGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
9800015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1131P
BCBS
—
05
—
2005627000
—
WV
01
—
25353
PARTNERS
—
05
—
5848571
—
VA
01
—
7954318
AETNA
—
01
—
79558
MEDCOST
—
05
—
891131P
—
NC
05
—
Q00011
—
SC
Enumeration date
12/08/2005
Last updated
02/08/2008
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