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DR. BRUCE ALLAN HARTWIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3 SHIRCLIFF WAY STE 752, SUITE 752, JACKSONVILLE, FL 32204-4786
(904) 389-6226
(904) 388-7265
Mailing address
3 SHIRCLIFF WAY STE 752, SUITE 752, JACKSONVILLE, FL 32204-4786
(904) 389-6226
(904) 388-7265

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0039317
FL
2084N0400X
Neurology Physician
ME003932000
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0623807
AETNA INS PROVIDER NUMBER
FL
01
130000461
RAILROAD MEDICARE NUMBER
FL
01
40188
AV-MED PROVIDER NUMBER
FL
01
592157126
TRICARE, UNITED HEALTHCAR
FL
Enumeration date
07/01/2005
Last updated
12/17/2019
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