Provider Demographics
NPI:1326662347
Name:BRUCE, CHRISTOPHER GLENN (MBCHB)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GLENN
Last Name:BRUCE
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 37TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2207
Mailing Address - Country:US
Mailing Address - Phone:202-340-3393
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 10, RM 2C713, 10 CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2081
Practice Address - Country:US
Practice Address - Phone:202-340-3393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23314207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology