Provider Demographics
NPI:1013907427
Name:BRUNTMYER, HANS CHRISTIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:CHRISTIAN
Last Name:BRUNTMYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 E SHERMAN BLVD STE 2400
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1886
Mailing Address - Country:US
Mailing Address - Phone:231-672-6336
Mailing Address - Fax:231-672-6335
Practice Address - Street 1:1150 E SHERMAN BLVD STE 2400
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1886
Practice Address - Country:US
Practice Address - Phone:231-672-6336
Practice Address - Fax:231-672-6335
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7399207P00000X
MI5101027552204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2047054BMedicare PIN