Individual
MICHAEL DEAN BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2240 SUTHERLAND AVE, SUITE 103, KNOXVILLE, TN 37919-2333
(865) 588-8831
(865) 588-8841
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27046
TN
207RP1001X
Pulmonary Disease Physician
Primary
27046
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290013994
RR MEDICARE
TN
05
—
3867691
—
TN
Enumeration date
06/28/2006
Last updated
04/04/2011
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