Individual
DR. WILLIAM C. BRUKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 RIDGE MEDICAL PLAZA, EDGEFIELD, SC 29824
(803) 637-1173
Mailing address
325 COLLETON AVE, AIKEN, SC 29801-7101
(803) 649-0308
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
20-09982
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099828
—
SC
Enumeration date
01/16/2007
Last updated
07/08/2007
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