Provider Demographics
NPI:1518509686
Name:REDLER, BRUCE HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:HOWARD
Last Name:REDLER
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 1:170 OAKANOAH CT
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-8485
Mailing Address - Country:US
Mailing Address - Phone:843-384-4710
Mailing Address - Fax:
Practice Address - Street 1:170 OAKANOAH CT
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8485
Practice Address - Country:US
Practice Address - Phone:843-384-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11749207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology