Individual
DR. BRUCE P CONMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29133
MN
207V00000X
Obstetrics & Gynecology Physician
4645
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0703070
MEDICA
MN
05
—
1396795407
—
MN
01
—
189P8C0
BC BS
MN
01
—
585240896131
PREFERRED ONE
MN
05
—
614072600
—
MN
Enumeration date
05/11/2006
Last updated
12/10/2012
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