Individual
DR. BRUCE WILKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
PO BOX 100, ROYAL OAK, MI 48068-0100
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101013957
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114450450
—
MI
05
—
114460985
—
MI
05
—
114461006
—
MI
05
—
114716348
—
MI
01
—
BW013957
BC/BS OF MICHIGAN
MI
Enumeration date
06/09/2006
Last updated
12/03/2014
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