Organization
BRUCE SHICKMANTER, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE J SHICKMANTER M.D. (PRESIDENT)
(413) 499-8515
Entity
Organization
Contact information
Practice address
777 NORTH ST, SUITE 201, PITTSFIELD, MA 01201-4147
(413) 499-8515
(413) 442-9161
Mailing address
777 NORTH ST, SUITE 201, PITTSFIELD, MA 01201-4147
(413) 499-8515
(413) 442-9161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7768
CDPHP
NY
05
—
9703641
—
MA
01
—
M17611
BCBSMA
MA
Enumeration date
01/20/2006
Last updated
08/22/2020
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