Staeheli, Bruce Wayne
Staeheli, Bruce Wayne is an individual health care provider with primary practice located at 119 Clubhouse Pl , Elk City OK 73644-7301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Staeheli, Bruce Wayne can be contacted via phone (580) 303-4664.Contact Information
Primary practice address
119 Clubhouse Pl
Elk City OK 73644-7301
Phone: (580) 303-4664
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 35 072661 | Ohio |
Profile Details
| NPI number | 1508998899 |
|---|---|
| LBN Legal business name | Staeheli, Bruce Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Sep 16th, 2008 - about 18 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 | 1508998899 | NPPES |
| West Virginia | Other | 1062641 | WV DWC |
| West Virginia | Other | 000000561000 | WV DWC |
| West Virginia | MEDICAID | 3810012159 | WV DWC |
| West Virginia | Other | 000000381808 | WV DWC |
| West Virginia | MEDICAID | 2015698 | WV DWC |
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