Provider Demographics
NPI:1477846046
Name:TJADEN, BRUCE L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:TJADEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:713-512-7200
Practice Address - Street 1:110 MARTER AVE STE 503
Practice Address - Street 2:BLDG 5
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3120
Practice Address - Country:US
Practice Address - Phone:856-608-8840
Practice Address - Fax:856-722-1898
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2020-11-30
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Provider Licenses
StateLicense IDTaxonomies
KS94-07612208600000X
TXR41532086S0129X
NJ25MA109367002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery