Healthcare Provider Details

I. General information

NPI: 1538274592
Provider Name (Legal Business Name): BRUCE ZIRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 PROFESSIONAL DR SUITE 170
LAWRENCEVILLE GA
30046-3367
US

IV. Provider business mailing address

PO BOX 370
FORTSON GA
31808-0370
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-2663
  • Fax: 770-962-8581
Mailing address:
  • Phone:
  • Fax: 706-494-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number38862
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number61542
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: