Provider Demographics
NPI:1447207576
Name:BRUNER, CHRISTINE R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:R
Last Name:BRUNER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1250 JOHN B WHITE SR BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-3929
Mailing Address - Country:US
Mailing Address - Phone:864-574-0017
Mailing Address - Fax:864-574-6088
Practice Address - Street 1:151 SOUTHHALL LN
Practice Address - Street 2:STE 300
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7176
Practice Address - Country:US
Practice Address - Phone:407-875-2080
Practice Address - Fax:407-650-3455
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC33363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC2552D267Medicare PIN