MEDICARE: BRUCE E KING M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Q00000X	Pathology Specialist/Technologist	MD065935L	PA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD065935L	PA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	220025955	OTHER	PA	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	50056060	OTHER	PA	CAPITAL BLUE CROSS & KEYSTONE HEALTH PLAN CENTRAL
3	53372	OTHER	PA	GEISINGER
4	2059148000	OTHER	PA	INDEPENDENCE BLUE CROSS
5	1150134	OTHER	PA	AETNA-HMO
6	20010382	OTHER	PA	MERCY
7	001366965	OTHER	PA	HIGHMARK
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	30002667	OTHER	PA	KEYSTONE MERCY
10	000000126590	OTHER	PA	UNISON
11	7860804	OTHER	PA	AETNA-NON HMO

NPI Number	:	1194798173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE E KING M.D.

Provider Business Mailing Address
First Line	:	555 N DUKE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17602-2250
Country	:	US
Telephone Number	:	717-544-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 N DUKE ST
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17602-2250
Country	:	US
Telephone Number	:	717-544-5511
Fax Number	:

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	10/28/2019