Provider Demographics
NPI:1689620080
Name:BRUEHLMAN, RICHARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:BRUEHLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5548 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9362
Mailing Address - Country:US
Mailing Address - Phone:724-444-6330
Mailing Address - Fax:724-444-0607
Practice Address - Street 1:5548 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9315
Practice Address - Country:US
Practice Address - Phone:724-444-6330
Practice Address - Fax:724-444-0607
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029483E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA482605OtherHIGHMARK
PA0010812820001Medicaid
PA482605OtherHIGHMARK
PAB42223Medicare UPIN