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Individual

JOHN M BRUZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3615 CHESTNUT STREET, RALSTON - PENN CENTER, PHILADELPHIA, PA 19104-2612
(215) 662-2746
(215) 349-5648
Mailing address
3615 CHESTNUT STREET, RALSTON - PENN CENTER, PHILADELPHIA, PA 19104-2612
(215) 662-2746
(215) 349-5648

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD064174L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016745200001
PA
Enumeration date
06/14/2006
Last updated
03/08/2012
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