NPI 1114160215

Michael Ryan Brunson, MD

Practitioner Pediatric Adolescent Medicine Physician Apo, AP

Practice location

Address: 35th Mdg Unit 5024, Apo, AP 96319
Phone: (315) 226-6495
Mailing address: 4102 Pinion Drive, 10th Medical Group, Usaf Academy, CO 80840-2502

Registered specialties (3)

Pediatric Adolescent Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2080A0000X Licence 26095 (NE)

Other Pediatrics providers in Armed Forces Pacific →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Armed Forces Pacific →

Pediatrics Physician

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 26095 (NE)

Registry record

NPI: 1114160215
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Apr 2009
Record last updated: 30 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.