Individual
BRUCE WILLHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 M L KING JR WAY, ATTN: PEDIATRIX MEDICAL GROUP, TACOMA, WA 98405-4234
(253) 403-1019
Mailing address
315 M L KING JR WAY, ATTN: PEDIATRIX MEDICAL GROUP, TACOMA, WA 98405-4234
(253) 403-1019
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
22636
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8306540
—
WA
Enumeration date
05/10/2006
Last updated
07/08/2007
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