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Individual

LESLIE A BRUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8871
(319) 384-8053
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8871
(319) 384-8053

Taxonomy

Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
36532
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11086
WELLMARK BCBS
IA
01
11646
WELLMARK BCBS
IA
05
1536318
IA
05
2536318
IA
Enumeration date
04/28/2006
Last updated
11/27/2007
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