Individual
JACOB BRUGGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3003 UNIVERSITY DR, MARINETTE, WI 54143-4110
(321) 948-9518
Mailing address
3003 UNIVERSITY DR, MARINETTE, WI 54143-4110
(321) 948-9518
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20774875
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171557
—
WI
Enumeration date
04/11/2018
Last updated
12/28/2021
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