Organization
BRUCE PIERSON JR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE H PIERSON JR. MD (PRESIDENT)
(304) 424-4640
Entity
Organization
Contact information
Practice address
600 18TH STREET, SUITE 311, PARKERSBURG, WV 26101
(304) 424-4640
(304) 424-4628
Mailing address
600 18TH STREET, SUITE 311, PARKERSBURG, WV 26101
(304) 424-4640
(304) 424-4628
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10635
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0296979
OH MEDICAID
OH
05
—
3810009741
—
WV
01
—
DG2883
RR MEDICARE
—
Enumeration date
12/11/2006
Last updated
12/18/2007
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