Provider Demographics
NPI:1770540346
Name:MARCEL, BRUCE RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RAYMOND
Last Name:MARCEL
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 1:47 OBERY ST
Mailing Address - Street 2:STE 201
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2230
Mailing Address - Country:US
Mailing Address - Phone:508-747-1560
Mailing Address - Fax:508-747-5155
Practice Address - Street 1:47 OBERY ST
Practice Address - Street 2:STE 201
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2230
Practice Address - Country:US
Practice Address - Phone:508-747-1560
Practice Address - Fax:508-747-5155
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36045207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B32103Medicare ID - Type Unspecified
B97072Medicare UPIN