Bruce, Mark D

Bruce, Mark D is an individual health care provider with primary practice located at 19333 W North Ave , Brookfield WI 53045-4132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bruce, Mark D can be contacted via phone (262) 785-2060.

Contact Information

Primary practice address
19333 W North Ave Brookfield WI 53045-4132
Phone: (262) 785-2060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 25131 Wisconsin

Profile Details

NPI number 1649381351
LBN Legal business name Bruce, Mark D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 30th, 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 1649381351 NPPES
Wisconsin MEDICAID 32658800
Wisconsin Other 391204982014
Wisconsin MEDICAID 30019300

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