Brunk, Glen A.

Brunk, Glen A. is an individual health care provider with primary practice located at 679 E County Line Rd , Greenwood IN 46143-1049. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brunk, Glen A. can be contacted via phone (317) 859-7222.

Contact Information

Primary practice address
679 E County Line Rd Greenwood IN 46143-1049
Phone: (317) 859-7222
Fax: (317) 859-7220
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01026203A Indiana

Profile Details

NPI number 1174537914
LBN Legal business name Brunk, Glen A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Mar 17th, 2021 - about 3 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 1174537914 NPPES
Indiana Other 100194370 MEDICAID GROUP NUMBER
Indiana Other 340012486 MEDICAID GROUP NUMBER
Indiana Other 000000091688 MEDICAID GROUP NUMBER
Indiana Other 340012514 MEDICAID GROUP NUMBER
Indiana Other 1487680518 MEDICAID GROUP NUMBER
Indiana MEDICAID 100352480 MEDICAID GROUP NUMBER
Indiana Other 340012500 MEDICAID GROUP NUMBER

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