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Individual

DR. BRUCE IRA IDELKOPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22536
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0265008
PREFERRED ONE
MN
01
0501641
MEDICA
MN
01
07620ID
BCBS OF MN
MN
01
100288C029
UCARE
MN
01
130005771
RAILROAD MEDICARE
MN
01
25828
AMERICA'S PPO
MN
05
30203900
MN
05
489092200
MN
01
HP13585
HEALTHPARTNERS
MN
Enumeration date
05/28/2006
Last updated
12/02/2011
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