Individual
MICHAEL ROBERT BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2910 N 3RD AVE, PHOENIX, AZ 85013-4434
(844) 324-6684
Mailing address
8070 ELLIS RD, BARTLETT, TN 38133-2806
(810) 305-2825
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
04/07/2026
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