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Individual
DR. DAVID BRUCE TICK
Active
Individual
DR. DAVID BRUCE TICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34022
WI
207SG0201X
Clinical Genetics (M.D.) Physician
34022
WI
208000000X
Pediatrics Physician
34022
VA
Other
Enumeration date
03/10/2006
Last updated
05/17/2018
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