Provider Demographics
NPI:1629058599
Name:STRUMINGER, BRUCE BAIRD (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:BAIRD
Last Name:STRUMINGER
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 1:801 ENCINO PL NE STE F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2639
Mailing Address - Country:US
Mailing Address - Phone:505-272-1312
Mailing Address - Fax:505-272-2240
Practice Address - Street 1:801 ENCINO PL NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2639
Practice Address - Country:US
Practice Address - Phone:505-272-1312
Practice Address - Fax:505-272-2240
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074075207R00000X
NMNM2013-0849207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48485349Medicaid
NM59203765Medicaid
AZ718497Medicaid
8HAV96Medicare ID - Type Unspecified
CO48485349Medicaid