Individual
CRAIG MATTHEW BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5800 FOXRIDGE DR, STE 240, MISSION, KS 66202-2338
(913) 261-3153
(913) 262-3295
Mailing address
5800 FOXRIDGE DR, STE 240, MISSION, KS 66202-2338
(913) 261-3153
(913) 262-3295
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-27631
KS
2085R0202X
Diagnostic Radiology Physician
2000172082
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100381650A
—
KS
05
—
100381650B
—
KS
05
—
205166101
—
MO
Enumeration date
06/10/2005
Last updated
05/17/2016
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