Provider Demographics
NPI:1811968241
Name:BRUGMANN, STEVEN RAY (PA-C)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RAY
Last Name:BRUGMANN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:COMDT (CG-1122)
Mailing Address - Street 2:USCG 2100ND ST SW, SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:409-766-5661
Mailing Address - Fax:409-766-4765
Practice Address - Street 1:COMDT (CG-1122)
Practice Address - Street 2:USCG 2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:409-766-5661
Practice Address - Fax:409-766-4765
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063201363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical