Healthcare Provider Details

I. General information

NPI: 1154160927
Provider Name (Legal Business Name): MATTHEW BRUCE DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 06/08/2024
Certification Date: 06/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S STATE ST STE 215
ANN ARBOR MI
48104-7103
US

IV. Provider business mailing address

2800 S STATE ST STE 215
ANN ARBOR MI
48104-7103
US

V. Phone/Fax

Practice location:
  • Phone: 734-547-3990
  • Fax: 734-547-3980
Mailing address:
  • Phone: 734-547-3990
  • Fax: 734-547-3980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW D BRUCE
Title or Position: FAMILY PRACTICIONER
Credential: DO
Phone: 734-547-3990