Individual
DR. MARTIN BRUCE NEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
1014 E ST, CHARLESTON, IL 61920-2524
(217) 345-7506
Mailing address
1014 E ST, CHARLESTON, IL 61920-2524
(217) 345-7506
(217) 345-7507
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60201211
BLUE CROSS BLUE SHIELD
IL
01
—
P00182659
RAILROAD MEDICARE
IL
Enumeration date
02/25/2007
Last updated
07/09/2007
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