Healthcare Provider Details

I. General information

NPI: 1679667554
Provider Name (Legal Business Name): BRUCE B NEUMANN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HEALTHY WAY
OLIVIA MN
56277
US

IV. Provider business mailing address

PO BOX 2290
MANITOWOC WI
54221-2290
US

V. Phone/Fax

Practice location:
  • Phone: 320-523-1261
  • Fax: 320-523-8493
Mailing address:
  • Phone: 920-320-2591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number313
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: