Brucker, Robert G

Brucker, Robert G is an individual health care provider with primary practice located at 2500 E Enterprise Unit C, Appleton WI 54913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Brucker, Robert G can be contacted via phone (920) 739-5642.

Contact Information

Primary practice address
2500 E Enterprise Unit C Appleton WI 54913
Fax: (920) 968-0259
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 22981 Wisconsin

Profile Details

NPI number 1972530004
LBN Legal business name Brucker, Robert G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Apr 3rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972530004 NPPES
Wisconsin MEDICAID 30810900

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