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NPI Code Detail

MEDICARE: DR. BRUCE MAXWELL NECKRITZ D.O.

MEDICARE: DR. BRUCE MAXWELL NECKRITZ D.O.
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
1208100000XPhysical Medicine & Rehabilitation PhysicianH0059310MD
2208100000XPhysical Medicine & Rehabilitation PhysicianOS5890FL

General Provider Information

NPI Number : 1588669360
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE MAXWELL NECKRITZ D.O.
Provider Business Mailing Address
First Line : 850 CENTRAL PKWY E STE 275
Second Line :
City : PLANO
State : TX
Zip : 75074-5542
Country : US
Telephone Number : 972-881-4688
Fax Number : 972-372-1657
Provider Business Practice Location Address
First Line : 10320 LITTLE PATUXENT PKWY STE 200
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-3344
Country : US
Telephone Number : 972-881-4688
Fax Number : 972-372-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 01/09/2023

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