Individual
DR. BRUCE STEWART WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 S 18TH ST, #203, FERNANDINA BEACH, FL 32034-4799
(904) 261-7707
(907) 261-8616
Mailing address
1340 S 18TH ST, #203, FERNANDINA BEACH, FL 32034-4799
(904) 261-7707
(907) 261-8616
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101042844
VA
208000000X
Pediatrics Physician
Primary
ME99878
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280146900
—
FL
05
—
6734952
—
VA
Enumeration date
03/14/2006
Last updated
08/17/2015
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