Brumbaugh, Dave R

Brumbaugh, Dave R is an individual health care provider with primary practice located at 1909 Vista Dr , Laramie WY 82070-5530. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Brumbaugh, Dave R can be contacted via phone (307) 745-8851.

Contact Information

Primary practice address
1909 Vista Dr Laramie WY 82070-5530
Phone: (307) 745-8851
Fax: (307) 742-0961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 388 Wyoming

Profile Details

NPI number 1114907722
LBN Legal business name Brumbaugh, Dave R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Jul 8th, 2007 - about 18 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 1114907722 NPPES
South Dakota MEDICAID 6826364

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