Provider Demographics
NPI:1508083635
Name:BRUCE, PAMELA PEMBER (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:PEMBER
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:541-881-2330
Mailing Address - Fax:541-881-2335
Practice Address - Street 1:1050 SW 3RD AVE
Practice Address - Street 2:STE 2600
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914
Practice Address - Country:US
Practice Address - Phone:541-881-2330
Practice Address - Fax:541-881-2335
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD151767208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery