Individual
W BRUCE FYE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
42882
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110202223
RAILROAD MEDICARE
MN
05
—
30178700
—
WI
05
—
462791100
—
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
SD
Enumeration date
01/06/2006
Last updated
05/22/2013
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