Individual
BRANDON JOHN BUKOVITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3916 N INTERTECH CT, APPLETON, WI 54913-6957
(920) 996-1000
Mailing address
3916 N INTERTECH CT, APPLETON, WI 54913-6957
(920) 996-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81497-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252233
—
WI
Enumeration date
06/21/2021
Last updated
07/23/2025
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