Healthcare Provider Details

I. General information

NPI: 1659328201
Provider Name (Legal Business Name): BRUCE C DRUMMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 FISH HATCHERY RD
MADISON WI
53715-1909
US

IV. Provider business mailing address

1211 FISH HATCHERY RD
MADISON WI
53715-1909
US

V. Phone/Fax

Practice location:
  • Phone: 608-252-8000
  • Fax: 608-283-7354
Mailing address:
  • Phone: 608-252-8000
  • Fax: 608-283-7354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number38612-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number38612-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: