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NPI Code Detail

MEDICARE: DR. TIMOTHY PETER BRUCE M.D.

MEDICARE:  DR. TIMOTHY PETER BRUCE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0005XUndersea and Hyperbaric Medicine (Emergency Medicine) Physician01070075AIN
2208200000XPlastic Surgery Physician125.068486IL
3390200000XStudent in an Organized Health Care Education/Training Program
4208200000XPlastic Surgery Physician80034-20WI

General Provider Information

NPI Number : 1013228907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY PETER BRUCE M.D.
Provider Business Mailing Address
First Line : N4W22370 BLUEMOUND RD
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-1683
Country : US
Telephone Number : 414-439-3000
Fax Number :
Provider Business Practice Location Address
First Line : 6002 N PORT WASHINGTON RD
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4524
Country : US
Telephone Number : 414-439-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2010
Last Update Date : 09/01/2022

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