Individual
ANGELINE D. BRUNETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 STONECREST BLVD, SMYRNA, TN 37167-6810
(615) 768-2000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28786
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3070530
BLUECROSS
TN
01
—
3126223
BLUECROSS
TN
05
—
3815216
—
TN
05
—
3815217
—
TN
01
—
P00232365
RAILROAD MEDICARE
TN
Enumeration date
06/13/2006
Last updated
11/12/2007
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