Provider Demographics
NPI:1043479769
Name:BRUELL, ESSIE WOODS (MD)
Entity type:Individual
Prefix:DR
First Name:ESSIE
Middle Name:WOODS
Last Name:BRUELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ESSIE
Other - Middle Name:JEANINE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7514 TRANQUILITY DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-9490
Mailing Address - Country:US
Mailing Address - Phone:423-503-0526
Mailing Address - Fax:
Practice Address - Street 1:7514 TRANQUILITY DR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-9490
Practice Address - Country:US
Practice Address - Phone:423-503-0526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN016279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine