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General NPI Number Information
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NPI Number | 1205965738
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Entity Type | Individual
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Provider Name | ROBERT M BRUCE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 4921 PARKVIEW PL SUITE 14E
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1032
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Country | US
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Telephone | 314-362-7276
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Fax |
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Provider Business Mailing Address
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Address Line | 3263 HAWTHORNE BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1618
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Country | US
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Telephone | 314-771-0862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | R4525
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License Number State | MO
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