Individual
TERRANCE BRUNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5438
(316) 652-0340
Mailing address
PO BOX 880, WICHITA, KS 67201-0880
(316) 685-8428
(316) 652-0340
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
04-28748
KS
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
04-28748
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058736
BCBS
KS
01
—
2220029506
RAILROAD MEDICARE
—
Enumeration date
01/21/2006
Last updated
09/11/2025
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