MEDICARE: BRUCE KENT WINNER MD

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	208D00000X	General Practice Physician	BW057232	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	080101081	OTHER	MI	RAILROAD MEDICARE

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	700C910950	OTHER	MI	BCBSM
4	BW057232	OTHER	MI	BCNBC

General Provider Information

NPI Number	:	1285734459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE KENT WINNER MD

Provider Business Mailing Address
First Line	:	601 JOHN ST
Second Line	:	BOX 42
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5341
Country	:	US
Telephone Number	:	269-341-7806
Fax Number	:	269-341-8743

Provider Business Practice Location Address
First Line	:	680 W COLUMBIA AVE
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-3028
Country	:	US
Telephone Number	:	269-965-4500
Fax Number	:	269-965-1150

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/26/2009

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Directions to “ BRUCE KENT WINNER MD” Practice Location

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