Organization
GLOVERSVILLE PHYSICIAN MEDICINE SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WHITMAN DO (PRESIDENT/DIRECTOR)
(800) 893-9698
Entity
Organization
Contact information
Practice address
99 E STATE ST, GLOVERSVILLE, NY 12078-1203
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03797537
—
NY
Enumeration date
10/24/2012
Last updated
05/11/2021
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