Provider Demographics
NPI:1497729636
Name:LING, BRUCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:S
Last Name:LING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 UNION AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2146
Mailing Address - Country:US
Mailing Address - Phone:724-226-2128
Mailing Address - Fax:724-226-2498
Practice Address - Street 1:1719 UNION AVE STE A
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2146
Practice Address - Country:US
Practice Address - Phone:724-226-2128
Practice Address - Fax:724-226-2498
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068693L174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH08146Medicare UPIN
PA034288D8SMedicare ID - Type Unspecified