Provider Demographics
NPI:1447523709
Name:GARRETT, BRUCE NEIL (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:NEIL
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 24TH ST NW
Mailing Address - Street 2:SUITE 17
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2543
Mailing Address - Country:US
Mailing Address - Phone:202-337-7660
Mailing Address - Fax:
Practice Address - Street 1:730 24TH ST NW
Practice Address - Street 2:SUITE 17
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2543
Practice Address - Country:US
Practice Address - Phone:202-337-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC11894207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology