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Individual

BRAD C RUNYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4575 BYRD DR, LOVELAND, CO 80538-7198
(970) 593-3300
Mailing address
1214 RUE CT, FORT COLLINS, CO 80526-3847
(970) 217-8861

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
35264
CO
207Y00000X
Otolaryngology Physician
Primary
35264
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01352640
CO
01
C446778
MEDICARE PTAN
CO
Enumeration date
06/12/2006
Last updated
11/08/2023
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