MEDICARE: BRUCE YOUNGER 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	207N00000X	Dermatology Physician	35045874	OH

General Provider Information

NPI Number	:	1396853180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE YOUNGER MD

Provider Business Mailing Address
First Line	:	2752 ERIE AVE
Second Line	:	SUITE #7
City	:	CINCINNATI
State	:	OH
Zip	:	45208
Country	:	US
Telephone Number	:	513-871-3302
Fax Number	:	513-871-3415

Provider Business Practice Location Address
First Line	:	2752 ERIE AVE
Second Line	:	SUITE #7
City	:	CINCINNATI
State	:	OH
Zip	:	45208
Country	:	US
Telephone Number	:	513-871-3302
Fax Number	:	513-871-3415

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/07/2023

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