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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649381351 | NPPES |
| Wisconsin | MEDICAID | 32658800 | |
| Wisconsin | Other | 391204982014 | |
| Wisconsin | MEDICAID | 30019300 |
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