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Individual

MR. BRUCE ALAN DANIELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4221 S WESTERN AVE, STE 4045, OKLAHOMA CITY, OK 73109-3447
(405) 636-1166
(405) 632-8446
Mailing address
4221 S WESTERN AVE, STE 4045, OKLAHOMA CITY, OK 73109-3447
(405) 636-1166
(405) 632-8446

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10948
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100100150A
OK
Enumeration date
11/07/2005
Last updated
09/22/2020
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