Provider Demographics
NPI:1568610103
Name:TRUMM, BRYAN NICHOLAS (MD, DPT)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:NICHOLAS
Last Name:TRUMM
Suffix:
Gender:M
Credentials:MD, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DELHI ST STE 4200
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6391
Mailing Address - Country:US
Mailing Address - Phone:563-557-5999
Mailing Address - Fax:563-557-5990
Practice Address - Street 1:1500 DELHI ST STE 4200
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001
Practice Address - Country:US
Practice Address - Phone:563-557-5999
Practice Address - Fax:563-557-5990
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004190225100000X
MN390200000X
IAMD-45200207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665463Medicaid
IA0665463Medicaid