Booth, Bruce W

Booth, Bruce W is an individual health care provider with primary practice located at 1051 Loftis Blvd Suite 100, Newport News VA 23606-3069. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Booth, Bruce W can be contacted via phone (757) 873-9400.

Contact Information

Primary practice address
1051 Loftis Blvd Suite 100 Newport News VA 23606-3069
Phone: (757) 873-9400
Fax: (757) 873-9420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0101021044 Virginia

Profile Details

NPI number 1164427993
LBN Legal business name Booth, Bruce W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Sep 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164427993 NPPES
Virginia Other 55199 OPTIMA
Virginia MEDICAID 006068138 OPTIMA
Virginia Other 110054751 OPTIMA

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