Individual
DR. MICHAEL L BRUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 S VAN BUREN RD, EDEN, NC 27288-5019
(336) 623-6862
Mailing address
117 E KINGS HWY, EDEN, NC 27288-5201
(314) 251-6930
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
036102870
IL
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
2020024355
MO
2085R0001X
Radiation Oncology Physician
036102870
IL
2085R0001X
Radiation Oncology Physician
Primary
2021-02075
NC
2085R0001X
Radiation Oncology Physician
90760
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102870
—
IL
Enumeration date
03/27/2006
Last updated
03/12/2024
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