Individual
BRUCE BIGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 HINCKLEY BLVD, SUITE 100, JACKSON, MI 49203-6125
(517) 784-0588
(517) 784-3866
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-0002
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301044701
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1716152
CIGNA HEALTHCARE
—
01
—
P00402208
RR MEDICARE
MI
Enumeration date
07/17/2006
Last updated
11/23/2007
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