Provider Demographics
NPI:1013280825
Name:JAMES F. BRUNGO, D.P.M.
Entity Type:Organization
Organization Name:JAMES F. BRUNGO, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNGO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:412-369-0255
Mailing Address - Street 1:8035 MCKNIGHT RD
Mailing Address - Street 2:ANDRE PLAZA, SUITE 104
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3036
Mailing Address - Country:US
Mailing Address - Phone:412-369-0255
Mailing Address - Fax:412-369-0488
Practice Address - Street 1:8035 MCKNIGHT RD
Practice Address - Street 2:SUITE 104
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3036
Practice Address - Country:US
Practice Address - Phone:412-369-0255
Practice Address - Fax:412-369-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
100961OtherMEDICARE ID - TYPE UNSPECIFIED
1002262OtherGATEWAY
103906OtherUPMC
PA1059129Medicaid
77828OtherUS HEALTHCARE
480019810OtherRAILROAD MEDICARE
100961OtherHIGHMARK
31785OtherHEALTH AMERICA
63853OtherMEDPLUS
77828OtherUS HEALTHCARE