| Keith R Bruno, MD | |
|
200 Crescent Center Pkwy, Department Of Dermatology, Tucker, GA 30084-7047 | |
| (770) 496-3605 | |
| (770) 496-3707 |
| Full Name | Keith R Bruno |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 37 Years |
| Location | 200 Crescent Center Pkwy, Tucker, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164530184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 038701 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Southeast Permanente Medical Group | 6204829013 | 658 |
| Entity Name | The Southeast Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith R Bruno, MD 3495 Piedmont Rd Ne, Nine Piedmont Center, Atlanta, GA 30305-1717 Ph: (404) 364-7000 | Keith R Bruno, MD 200 Crescent Center Pkwy, Department Of Dermatology, Tucker, GA 30084-7047 Ph: (770) 496-3605 |
Dr. Steven S Thomas, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 2185 Northlake Pkwy, Suite 104, Tucker, GA 30084 Phone: 770-934-7200 Fax: 770-934-7243 | |
Zlatan Oruc, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1777 Montreal Cir, Tucker, GA 30084 Phone: 770-934-9200 | |
Marvin B Kayes, PAC Dermatology Medicare: Not Enrolled in Medicare Practice Location: 200 Crescent Centre Park, Department Of Dermatology, Tucker, GA 30084 Phone: 770-496-3605 Fax: 770-496-3707 |