Provider Demographics
NPI:1679667554
Name:NEUMANN, BRUCE B (DPM)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:B
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2290
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54221-2290
Mailing Address - Country:US
Mailing Address - Phone:920-320-2591
Mailing Address - Fax:
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:
Practice Address - City:OLIVIA
Practice Address - State:MN
Practice Address - Zip Code:56277
Practice Address - Country:US
Practice Address - Phone:320-523-1261
Practice Address - Fax:320-523-8493
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN313213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI390806395294OtherBLUE CROSS BLUE SHIELD
WI43240400Medicaid
T65924Medicare UPIN
WI43240400Medicaid