Individual
DR. HEATHER BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 W BELVEDERE AVE, DEPT. OF PSYCHIATRY, BALTIMORE, MD 21215-5216
(410) 601-5461
(410) 601-6302
Mailing address
2401 W BELVEDERE AVE, DEPT. OF CREDENTIALING, BALTIMORE, MD 21215-5216
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0061963
MD
390200000X
Student in an Organized Health Care Education/Training Program
D0061963
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014028700
—
MD
01
—
CA8374
R/R MEDICARE GROUP
MD
01
—
P00689584
R/R MEDICARE
MD
Enumeration date
01/30/2007
Last updated
09/14/2012
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