Individual
DR. GERARD S BRUNGARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8533 E 32ND ST N, WICHITA, KS 67226-2611
(316) 293-2622
(855) 517-9494
Mailing address
PO BOX 1358, WICHITA, KS 67201-1358
(316) 293-3429
(316) 293-1882
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-20542
KS
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
04-20542
KS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
04-20542
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004372270003
—
KS
Enumeration date
07/05/2006
Last updated
08/03/2023
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