Organization
BRUCE A HARTWIG MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ALLAN HARTWIG MD (PRESIDENT/PHYSICIAN)
(904) 389-6226
Entity
Organization
Contact information
Practice address
3 SHIRCLIFF WAY, SUITE 752, JACKSONVILLE, FL 32204-4730
(904) 389-6226
(904) 388-7265
Mailing address
3 SHIRCLIFF WAY, SUITE 752, JACKSONVILLE, FL 32204-4730
(904) 389-6226
(904) 388-7265
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0039317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040188
AVMED
FL
01
—
130000461
RAILROAD MEDICARE
FL
01
—
210440
WELLCARE
FL
01
—
43727
HEALTHEASE
FL
01
—
623807
AETNA
FL
Enumeration date
08/19/2008
Last updated
09/12/2008
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