Individual
DR. BRUCE J SHICKMANTER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
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
44340
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00536214
—
NY
01
—
10034408
CDPHP
NY
01
—
16388
HEALTH NEW ENGLAND
MA
05
—
2071711
—
MA
01
—
773735
TUFTS HEALTHPLAN
MA
01
—
833694
MVP
NY
01
—
D82851
HARVARD PILGRIM HEALTHCAR
MA
01
—
I22260
BCBSMA
MA
Enumeration date
01/23/2006
Last updated
07/08/2007
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