Individual
DR. BRUCE A. ASAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD038812E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001257715 0006
—
PA
05
—
5026105
—
NJ
Enumeration date
07/11/2006
Last updated
10/06/2014
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