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Individual

DR. BRUCE P MATHIE

Active
Find providers by NPI
Individual

DR. BRUCE P MATHIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4803
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000223574
ANTHEM BLUE CROSS BLUE SH
OH
05
2039127
OH
01
2708610
AETNA
OH
01
OH4803
EYEMED
OH
Enumeration date
11/02/2005
Last updated
12/10/2020
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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