Provider Demographics
NPI:1932333945
Name:HUNTER, BRETT (IDMT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INDEPENDENCE DR
Mailing Address - Street 2:MEDICAL AID STATION, BLDG 418
Mailing Address - City:CAMP DOUGLAS
Mailing Address - State:WI
Mailing Address - Zip Code:54618-5001
Mailing Address - Country:US
Mailing Address - Phone:608-427-1214
Mailing Address - Fax:608-427-1225
Practice Address - Street 1:100 INDEPENDENCE DR
Practice Address - Street 2:MEDICAL AID STATION, BLDG 418
Practice Address - City:CAMP DOUGLAS
Practice Address - State:WI
Practice Address - Zip Code:54618-5001
Practice Address - Country:US
Practice Address - Phone:608-427-1214
Practice Address - Fax:608-427-1225
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians