Individual
DR. BRUCE LIRON MATCHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF OSTEOPATHY
Contact information
Practice address
CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER, 3001 GREEN BAY ROAD, NORTH CHICAGO, IL 60064
(847) 688-1900
Mailing address
8901 WISCONSIN AVENUE, NNMC - GME BUILDING 10 1ST FLOOR ROOM 1006, FPO, AA 20889-5600
(301) 319-8278
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2021016045
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
07/09/2008
Last updated
10/28/2021
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