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Individual

BRUCE BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1021 COOLIDGE ST, SUITE 4, GREENEVILLE, TN 37743-5986
(423) 636-8891
(423) 636-1732
Mailing address
PO BOX 37087, BALITMORE, TN 21297-3087
(828) 687-5616
(828) 650-8076

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
18527
TN
2083X0100X
Occupational Medicine Physician
28732
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1509400
TN
Enumeration date
08/14/2006
Last updated
06/24/2015
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