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Individual

BRUCE H DORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-7614
(706) 650-1034
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
(800) 394-4445

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101238082
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447241708
VA
Enumeration date
11/04/2005
Last updated
08/29/2008
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