Provider Demographics
NPI:1487856670
Name:BRUMFIELD, MICHAEL JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:285 W 12TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-1654
Mailing Address - Country:US
Mailing Address - Phone:765-475-2388
Mailing Address - Fax:260-479-2928
Practice Address - Street 1:285 W 12TH ST STE 112
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1654
Practice Address - Country:US
Practice Address - Phone:765-475-2388
Practice Address - Fax:260-479-2928
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004189A208600000X
AZ005854208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery