Provider Demographics
NPI:1649392184
Name:WEEKS, BRUCE MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:MATTHEW
Last Name:WEEKS
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 1:3828 LEE CT
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 FRONT ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1244
Practice Address - Country:US
Practice Address - Phone:907-364-4565
Practice Address - Fax:907-364-4469
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK55942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1016894Medicaid
AKMD6683Medicaid
AK8EB977Medicare PIN
AK8EB976Medicare PIN
AKI41262Medicare UPIN
AK8EB978Medicare PIN
AK8EB975Medicare PIN