Individual
BRUCE ALLEN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
Mailing address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12961
ND
2085R0202X
Diagnostic Radiology Physician
52223
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18613
—
ND
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
WI
Enumeration date
05/02/2008
Last updated
08/27/2014
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