Provider Demographics
NPI:1427221886
Name:BRUEN, KEVIN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JOHN
Last Name:BRUEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:SUITE 400E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6820
Mailing Address - Fax:406-238-6838
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 400E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6820
Practice Address - Fax:406-238-6838
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2014-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT5426453-1205208600000X
FL121272086S0129X
MT123512086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery