Provider Demographics
NPI:1447336854
Name:BRUCE, MERLE F (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:MERLE
Middle Name:F
Last Name:BRUCE
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 W 6TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4500
Mailing Address - Country:US
Mailing Address - Phone:775-786-9300
Mailing Address - Fax:775-786-9280
Practice Address - Street 1:236 W 6TH ST STE 107
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4500
Practice Address - Country:US
Practice Address - Phone:775-786-9300
Practice Address - Fax:775-786-9280
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3532174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC3532OtherFEDERAL BCBS NUMBER
NV11905OtherBCBS NUMBER
NVCC3532OtherFEDERAL BCBS NUMBER