Individual
MR. PATRICK MICHAEL BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3101 N 11TH ST, SUITE#2, BISMARCK, ND 58503-0594
(701) 224-9521
Mailing address
PO BOX 994, BISMARCK, ND 58502-0994
(701) 224-9521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4487
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23457
BC-BS INDIVIDUAL PROVIDER
ND
Enumeration date
03/28/2007
Last updated
07/08/2007
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