Individual
COREY SCOTT BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 E THOMAS RD, PHOENIX, AZ 85012-3204
(602) 351-2229
(602) 351-1500
Mailing address
1661 E CAMELBACK RD STE 205, PHOENIX, AZ 85016-3913
(602) 422-9000
(602) 556-5951
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29104
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1550956
HEALTH CHOICE PROVIDER ID
AZ
01
—
1Z5857
HEALTH NET PROVIDER ID
AZ
01
—
4872600
CIGNA PROVIDER ID
AZ
01
—
550956
AHCCCS PROVIDER ID
AZ
01
—
562285791
TAX ID
AZ
01
—
56228579101
PACIFICARE PROVIDER ID
AZ
01
—
AZ0720420
BCBS PROVIDER ID
AZ
Enumeration date
08/02/2005
Last updated
01/26/2021
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