Individual
ROBERT CARL BRUTKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6345 AIRPORT BLVD STE S, MOBILE, AL 36608-3127
(251) 344-1515
(251) 344-1455
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15937
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000008869
—
AL
01
—
051508869
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
07/07/2006
Last updated
02/07/2012
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