Individual
DR. ALLEN THOMAS BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
50 SEWALL ST, PORTLAND, ME 04102-2645
(207) 775-3526
(207) 775-5658
Mailing address
50 SEWALL ST, PORTLAND, ME 04102-2645
(207) 775-3526
(207) 775-5658
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
018852
ME
207N00000X
Dermatology Physician
4301083648
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315017780
CONTROLLED SUBSTANCE LICE
MI
Enumeration date
03/22/2007
Last updated
12/07/2011
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