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General NPI Number Information
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NPI Number | 1356517387
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Entity Type | Organization
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Legal Business Name | BRUCE E WEST MD PC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 27177 LAHSER RD STE 100
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City | SOUTHFIELD
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State | MI
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Zip | 48034-4714
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Country | US
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Telephone | 248-352-8970
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Fax |
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Provider Business Mailing Address
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Address Line | 27177 LAHSER RD STE 100
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City | SOUTHFIELD
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State | MI
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Zip | 48034-4714
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Country | US
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Telephone | 248-352-8970
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE E WEST
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Credential | MD
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Telephone | 248-352-8970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301051847
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License Number State | MI
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