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Individual

ALEXANDER J BRUNNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
40245
TN
208000000X
Pediatrics Physician
Primary
40245
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
083121
BOARD CERTIFICATION #
TN
01
40245
MEDICAL LICENSE#
TN
05
5440828
TN
Enumeration date
08/18/2006
Last updated
06/06/2019
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