Provider Demographics
NPI:1265423024
Name:ROTHSCHILD, BRUCE M (MD)
Entity type:Individual
Prefix:PROF
First Name:BRUCE
Middle Name:M
Last Name:ROTHSCHILD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9 N 7TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1880
Mailing Address - Country:US
Mailing Address - Phone:724-357-7196
Mailing Address - Fax:724-357-7279
Practice Address - Street 1:120 IRMC DR
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3674
Practice Address - Country:US
Practice Address - Phone:724-427-2762
Practice Address - Fax:724-427-2707
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2014-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-05-3672-R207RR0500X
PAMD451278207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0641596Medicaid
PA0011082050003Medicaid
PA344808NWBMedicare PIN
OH0588592Medicare PIN
KS104400Medicare PIN
PA0011082050003Medicaid
A16601Medicare UPIN