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Individual

GAVIN BRUNSVOLD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2868 ACTON RD, BIRMINGHAM, AL 35243-2502
(205) 968-8360
(205) 968-8373
Mailing address
2868 ACTON RD, BIRMINGHAM, AL 35243-2502
(205) 968-8360
(205) 968-8373

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
23452
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51509728
BCBS
AL
01
51510560
BCBS
AL
Enumeration date
05/24/2006
Last updated
07/08/2007
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