Provider Demographics
NPI:1528074192
Name:BRUNO, PETER DENIS (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DENIS
Last Name:BRUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5704
Mailing Address - Country:US
Mailing Address - Phone:703-442-8301
Mailing Address - Fax:703-790-1773
Practice Address - Street 1:1499 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5704
Practice Address - Country:US
Practice Address - Phone:703-442-8301
Practice Address - Fax:703-790-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031799207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA066932OtherANTHEM BC/BS OF VA
16496OtherNCPPO
VA31799OtherMUTUAL OF OMAHA
0004269897OtherAETNA PPO
DC2479OtherBC/BS OF DC
C62508Medicare UPIN
VA066932OtherANTHEM BC/BS OF VA