Provider Demographics
NPI:1740442995
Name:BRUEN, CHARLES ALAN (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ALAN
Last Name:BRUEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:8170 33RD AVE S MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-3456
Mailing Address - Fax:651-254-5216
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:MS11102F
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-3456
Practice Address - Fax:651-254-5216
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2016-09-06
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Provider Licenses
StateLicense IDTaxonomies
MN53290207P00000X, 207RC0200X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine