Organization
BRUCE R STEVENS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ROBERT STEVENS MD (PSYCHIATRIST)
(414) 967-4930
Entity
Organization
Contact information
Practice address
1601 E BLACKTHORNE PL, MILWAUKEE, WI 53211-1139
(414) 967-4930
(414) 967-5730
Mailing address
1601 E BLACKTHORNE PL, MILWAUKEE, WI 53211-1139
(414) 967-4930
(414) 967-5730
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34578
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31971700
—
WI
Enumeration date
12/14/2006
Last updated
08/22/2020
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