Individual
DR. BRENT STEVEN BRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4353 DODGE ST, OMAHA, NE 68131-2709
(402) 552-2020
(402) 552-2367
Mailing address
4353 DODGE ST, OMAHA, NE 68131-2709
(402) 552-2020
(402) 552-2367
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35687
NE
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
35687
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47080542812
—
NE
Enumeration date
06/21/2018
Last updated
01/18/2024
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