Individual
DR. BRUCE ALFRED ST AMOUR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1900 ELECTRIC RD, SALEM, VA 24153-7494
(540) 776-4000
(540) 776-4196
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102205608
VA
207P00000X
Emergency Medicine Physician
014898
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114773193
—
MI
05
—
114832768
—
MI
01
—
BS014898
BLUE SHIELD
MI
Enumeration date
06/12/2006
Last updated
05/28/2019
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