Healthcare Provider Details

I. General information

NPI: 1922098292
Provider Name (Legal Business Name): ROBERT C BRUCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E 13TH ST
LOVELAND CO
80537-5113
US

IV. Provider business mailing address

1627 E 18TH ST
LOVELAND CO
80538-4209
US

V. Phone/Fax

Practice location:
  • Phone: 970-663-5437
  • Fax: 970-669-5762
Mailing address:
  • Phone: 970-663-0135
  • Fax: 970-461-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33373
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: