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Individual

DR. BRUCE D. NOLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
349 E CORONADO RD, PHOENIX, AZ 85004-1525
(602) 266-5678
(602) 264-5646
Mailing address
3020 E CAMELBACK RD, SUITE 301, PHOENIX, AZ 85016-5095
(602) 264-9100
(602) 264-9101

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
22429
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120390
GROUP MEDICARE NUMBER
AZ
05
176017-05
AZ
01
317047
GROUP MEDICAID NUMBER
AZ
Enumeration date
05/11/2006
Last updated
02/17/2017
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