Provider Demographics
NPI:1124378047
Name:BRUGMAN, SEAN (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BRUGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BDAACH - BLDG 3031
Mailing Address - Street 2:CAMP HUMPHREYS, PYEONGTAEK, S. KOREA
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BDAACH
Practice Address - Street 2:CAMP HUMPHREYS - BLD 3130, PYEONGTAEK, S. KOREA
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:96205
Practice Address - Country:US
Practice Address - Phone:031-690-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17041208D00000X
HIMD-17041207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI17041Medicare UPIN