Individual
BRUCE A MCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 388-1636
(541) 388-1719
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 388-1636
(541) 388-1719
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD15503
OR
207RC0000X
Cardiovascular Disease Physician
MD15503
OR
207RI0011X
Interventional Cardiology Physician
Primary
MD15503
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208371
—
OR
Enumeration date
01/20/2006
Last updated
12/07/2022
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