Individual
DR. VAN H DE BRUYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11220 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211
(501) 399-4212
(501) 868-7551
Mailing address
12 SPRING VALLEY LN, LITTLE ROCK, AR 72223-4494
(501) 399-4212
(501) 868-7551
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
E-1621
AR
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
E-1621
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133844001
—
AR
01
—
89-V554
MALP INS
AR
Enumeration date
07/13/2006
Last updated
01/12/2019
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