Basic Information
| Provider Information | |||||||||
| NPI: | 1497763445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRONANDER | ||||||||
| FirstName: | KIRK | ||||||||
| MiddleName: | ALAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 MILL STREET | ||||||||
| Address2: | W11 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753275174 | ||||||||
| FaxNumber: | 7753275178 | ||||||||
| Practice Location | |||||||||
| Address1: | 1155 MILL STREET | ||||||||
| Address2: | W11 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753275174 | ||||||||
| FaxNumber: | 7753275178 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 02/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9851 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.