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Individual
BRUCE A ANDERSEN
Active
Individual
BRUCE A ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
163
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005351
BCBS
—
01
—
10478
PRESBYTERIAN HP
—
Enumeration date
10/03/2006
Last updated
05/07/2008
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