Bullion, Bruce L

Bullion, Bruce L is an individual health care provider with primary practice located at 1960 28Th St Se , Grand Rapids MI 49508-7900. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bullion, Bruce L can be contacted via phone (616) 247-6677.

Contact Information

Primary practice address
1960 28Th St Se Grand Rapids MI 49508-7900
Phone: (616) 247-6677
Fax: (616) 247-1254
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901004093 Michigan

Profile Details

NPI number 1003814492
LBN Legal business name Bullion, Bruce L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Oct 25th, 2007 - about 19 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 1003814492 NPPES
Michigan MEDICAID 4634126
Michigan MEDICAID 4703359
Michigan MEDICAID 4939450
Michigan MEDICAID 4930876
Michigan MEDICAID 4947087

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