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Individual

BRUCE NEWSWANGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 523-3160
Mailing address
PO BOX 419569, BOSTON, MA 02241-9569
(781) 280-1699
(781) 276-6454

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
02001536
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000082207
ANTHEM
IN
05
113067774
MI
05
200331530
IN
01
930017086
RAIL ROAD MEDICARE
IN
Enumeration date
03/07/2006
Last updated
12/07/2023
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