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Individual

BRUCE LEBOWITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0453
Mailing address
PO BOX 64664, BALTIMORE, MD 21264-4664
(410) 550-0453

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00349
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600638802
MD
Enumeration date
06/12/2006
Last updated
01/29/2013
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