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Individual

BRUCE WILLIAM HENKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-4019
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-4019

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22475
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
915283100
MN
Enumeration date
11/28/2006
Last updated
05/19/2011
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