Provider Demographics
NPI:1497861025
Name:KRESSEL, BRUCE R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:R
Last Name:KRESSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 K ST NW
Mailing Address - Street 2:SUITE 707
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1810
Mailing Address - Country:US
Mailing Address - Phone:202-293-5382
Mailing Address - Fax:202-429-0617
Practice Address - Street 1:2141 K ST NW
Practice Address - Street 2:SUITE 707
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-293-5382
Practice Address - Fax:202-429-0617
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 7655207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777021900Medicaid
DC1670-0002OtherCAREFIRST BCBS
DC022749100Medicaid
MD777021900Medicaid