Provider Demographics
NPI:1417901455
Name:BRUHL, MARTIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:G
Last Name:BRUHL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:393 NORTH DUNLAP STREET STE 725
Mailing Address - Street 2:LEXINGTON EYE ASSOCIATES PA
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4298
Mailing Address - Country:US
Mailing Address - Phone:651-646-7419
Mailing Address - Fax:651-637-2778
Practice Address - Street 1:393 NORTH DUNLAP STREET STE 725
Practice Address - Street 2:LEXINGTON EYE ASSOCIATES PA
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4298
Practice Address - Country:US
Practice Address - Phone:651-646-7419
Practice Address - Fax:651-646-7419
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-09-27
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Provider Licenses
StateLicense IDTaxonomies
MNE15851207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A94235Medicare UPIN