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Individual
MARY E BRUCE
Active
Individual
MARY E BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
009354-1
NY
363AS0400X
Surgical Physician Assistant
Primary
50.006760RX
OH
363AS0400X
Surgical Physician Assistant
PA2344
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07950511
—
MS
05
—
199763795
—
AR
05
—
Q002143
—
TN
Enumeration date
08/28/2006
Last updated
04/21/2021
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