Provider Demographics
NPI:1013904077
Name:BRUNGO, JAMES FRANCIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:BRUNGO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8035 MCKNIGHT RD
Mailing Address - Street 2:STE 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:STE 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002415L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1002262OtherGATEWAY
63853OtherMEDPLUS
31785OtherHEALTH AMERICA
480019810OtherRAILROAD MEDICARE
PA1059129Medicaid
77828OtherUS HEALTHCARE
100961OtherHIGHMARK
103906OtherUPMC
480019810OtherRAILROAD MEDICARE
1002262OtherGATEWAY