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Individual
BRUCE LAUREN CHAROUS
Active
Individual
BRUCE LAUREN CHAROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
26268
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30596100
—
WI
01
—
P01142239
RR MEDICARE
WI
Enumeration date
06/20/2006
Last updated
04/01/2013
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