DR. WALLACE JOHN BRUDER M.D.
NPI 1396769220
Orthopaedic Surgery in Traverse City, MI

Active since July 26, 2006
4045 W ROYAL DR, TRAVERSE CITY, MI 49684(231) 935-0900(231) 935-0308 Get Directions Write a Review

NPPES record last updated: February 3, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Wallace John Bruder M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WALLACE JOHN BRUDER M.D. (NPI 1396769220) is an individual orthopaedic surgery provider in Traverse City, Michigan, licensed in Michigan (4301033897) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1396769220
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. WALLACE JOHN BRUDERCredential: M.D.
Location Address4045 W ROYAL DRTraverse City, MI 49684-8965
Mailing Address4045 W Royal DrTraverse City, MI 49684-8965 · (231) 935-0900 · Fax (231) 935-0308
Fax(231) 935-0308
Sole ProprietorNo
Enumeration DateJuly 26, 2006
Last NPPES UpdateFebruary 3, 2011
NPI 1396769220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in MI · 4301033897
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
4045 W ROYAL DR, Traverse City, MI 49684

Other Identifiers 3

Medicare UPINA77100MI
Medicare ID-Type Unspecified0M00980
Medicaid103104985MI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Physical Therapy Assistant
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Orthopaedic Surgery
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Physician Assistant
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Nurse Practitioner
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Physical Therapy Assistant
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Orthopaedic Surgery (Sports Medicine)
4045 W ROYAL DR
TRAVERSE CITY, MI 49684
Physical Therapist (Orthopedic)
4045 W ROYAL DR
TRAVERSE CITY, MI 49684

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wallace Bruder's NPI number?

The NPI number for Wallace Bruder is 1396769220. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Wallace Bruder located?

Wallace Bruder practices at 4045 W Royal Dr, Traverse City, MI 49684. The listed phone number is (231) 935-0900.

What is Wallace Bruder's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

When was this NPI record last updated?

The NPPES record for Wallace Bruder was last updated on February 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.