Individual
BRUCE M BERENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
166 4TH ST E, SAINT PAUL, MN 55101-1421
(651) 292-2043
(651) 292-2204
Mailing address
166 4TH ST E, SAINT PAUL, MN 55101-1421
(651) 292-2043
(651) 292-2204
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33731
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811994858
—
MN
Enumeration date
07/06/2005
Last updated
09/26/2011
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