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Individual

DR. BRUCE KEVIN WAITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1000 FIRST DR NW, AUSTIN, MN 55912-2941
(507) 433-7351
(507) 668-2975
Mailing address
404 W. FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384
(507) 668-2975

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
62771
MN
207V00000X
Obstetrics & Gynecology Physician
DO17052
OR
207V00000X
Obstetrics & Gynecology Physician
DO1972
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025226
OR
Enumeration date
05/24/2005
Last updated
07/21/2022
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