Individual
BRUCE A LUXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
3800 RESERVOIR RD NW, 5 PHC, WASHINGTON, DC 20007-2113
(202) 444-7520
(202) 444-7797
Mailing address
PO BOX 418283, BOSTON, MA 02241-8283
(703) 558-1544
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36863
IA
207RG0100X
Gastroenterology Physician
Primary
36863
IA
207RI0008X
Hepatology Physician
36863
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0735969
—
IA
01
—
25281
WELLMARK BCBS
IA
Enumeration date
09/14/2006
Last updated
03/09/2012
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