MEDICARE: DR. BRUCE ALLEN SCUDDAY DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	1149	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073574943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE ALLEN SCUDDAY DPM

Provider Business Mailing Address
First Line	:	1700 CURIE DR
Second Line	:	SUITE #4000
City	:	EL PASO
State	:	TX
Zip	:	79902-2905
Country	:	US
Telephone Number	:	915-533-5151
Fax Number	:	915-533-5187

Provider Business Practice Location Address
First Line	:	1700 CURIE DR
Second Line	:	SUITE #4000
City	:	EL PASO
State	:	TX
Zip	:	79902-2905
Country	:	US
Telephone Number	:	915-533-5151
Fax Number	:	915-533-5187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	05/25/2012

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Directions to “ DR. BRUCE ALLEN SCUDDAY DPM” Practice Location

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