Provider Demographics
NPI:1265429476
Name:BRUNO, LAWRENCE PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:PAUL
Last Name:BRUNO
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 1:19250 BAGLEY RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3347
Mailing Address - Country:US
Mailing Address - Phone:440-826-0770
Mailing Address - Fax:440-826-0775
Practice Address - Street 1:19250 BAGLEY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3347
Practice Address - Country:US
Practice Address - Phone:440-826-0770
Practice Address - Fax:440-826-0775
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049736207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0731980Medicaid
OH34161856300OtherBWC
OH34161856300OtherBWC
OHBR0628421Medicare ID - Type Unspecified
OH0731980Medicaid