Individual
BRUCE R PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 N WASHINGTON ST, DEAN MEDICAL CENTER, JANESVILLE, WI 53548-2908
(608) 755-3500
(608) 755-3500
Mailing address
580 N WASHINGTON ST, DEAN MEDICAL CENTER, JANESVILLE, WI 53548-2908
(608) 755-3500
(608) 755-3500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
19639-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040
DEAN HEALTH INSURANCE
WI
05
—
31178900
—
WI
Enumeration date
05/16/2006
Last updated
07/08/2007
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