Provider Demographics
NPI:1407834724
Name:BRUCE, MICHELLE TOWNSEND (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:TOWNSEND
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 DR. D. B. TODD BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-327-6438
Mailing Address - Fax:615-327-5634
Practice Address - Street 1:1005 DR. D. B. TODD BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6438
Practice Address - Fax:615-327-5634
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN288952083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3330113Medicaid
TNI30002Medicare UPIN
TN3330113Medicaid