Individual
BRUCE C WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18181 OAKWOOD BLVD, SUITE 102, DEARBORN, MI 48124-5032
(313) 982-5533
(313) 982-5508
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301039685
MI
2086S0129X
Vascular Surgery Physician
4301039685
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104432256
—
MI
Enumeration date
05/03/2006
Last updated
01/30/2014
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