Robert Bruha
Nephrologist
1404 Eastland Dr Ste 103
Bloomington
, Illinois 61701-7904
Robert Bruha
Nephrologist
1404 Eastland Dr Ste 103
Bloomington
, Illinois 61701-7904
(309) 676-8455
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Robert Bruha
- 420 Ne Glen Oak Ave Ste 401
- Peoria, IL
- Zip : 61603-3168
- Fax : (309) 676-8455
- Phone : (309) 676-8123
Second Address
- Robert Bruha
- 1404 Eastland Dr Ste 103
- Bloomington, IL
- Zip : 61701-7904
- Fax : (309) 676-8455
- Phone : (309) 676-8123
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | 036109216 | IL |
National Provider Identifier
| NPI | 1043340367 |
|---|---|
| Provider Name | Robert Bruha |
| First Address | Peoria, IL 61603-3168 |
| Second Address | Bloomington, IL 61701-7904 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/03/2007 |
| Last Update Date | 15/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036109216 | (05) | IL |
| G56104 | (02) | IL |
| P00047015 | RAILROAD MEDICARE (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.