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General NPI Number Information
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NPI Number | 1710449475
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Entity Type | Individual
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Provider Name | ROBERT BRUCE MD
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Gender | Male
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-2355
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Country | US
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Telephone | 352-273-8610
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Fax |
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Provider Business Mailing Address
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Address Line | 262 ASHBOURNE TRL
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-2355
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Country | US
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Telephone | 770-822-9143
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 92983
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME170506
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 92983
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License Number State | GA
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