Individual
BRUCE M MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3717
(203) 384-4132
Mailing address
PO BOX 415126, BOSTON, MA 02241-5126
(203) 384-3975
(203) 384-3829
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
020490
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001204908
—
CT
Enumeration date
11/22/2005
Last updated
11/09/2010
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