Provider Demographics
NPI:1063467629
Name:SEGAL, BRUCE A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:SEGAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5258 LINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6530
Mailing Address - Country:US
Mailing Address - Phone:561-498-3664
Mailing Address - Fax:561-496-2493
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6530
Practice Address - Country:US
Practice Address - Phone:561-498-3664
Practice Address - Fax:561-496-2493
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2008-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME57366207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4389370001Medicare NSC
FL10232Medicare PIN
E85412Medicare UPIN