Individual
DR. BRENT R BULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MAYO CLINIC HEALTH SYSTEM MANKATO, 1025 MARSH ST, MANKATO, MN 56001
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
39741
MN
Other
Enumeration date
05/16/2006
Last updated
02/22/2022
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