Provider Demographics
NPI:1922086388
Name:BRUMWELL, ERIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:P
Last Name:BRUMWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1344 WINTERGREEN LN NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-5118
Mailing Address - Country:US
Mailing Address - Phone:206-842-5632
Mailing Address - Fax:206-842-5992
Practice Address - Street 1:1344 WINTERGREEN LN NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-5118
Practice Address - Country:US
Practice Address - Phone:206-842-5632
Practice Address - Fax:206-842-5992
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA60440577207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN