Individual
DR. BRUCE ROBERT STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1806 SUMMIT AVE STE 300, RICHMOND, VA 23230-4339
(804) 362-2227
(804) 362-2228
Mailing address
2151 S STARLIGHT DR, COEUR D ALENE, ID 83814-5827
(804) 929-8682
(804) 362-2228
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101244688
VA
2084P0800X
Psychiatry Physician
34578
WI
2084P0800X
Psychiatry Physician
M-15170
ID
2084P0800X
Psychiatry Physician
MD.MD.61113530
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260029980
RR MED
—
01
—
C06115
GROUP PTAN
VA
Enumeration date
04/13/2006
Last updated
11/25/2023
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