Provider Demographics
NPI:1295711091
Name:BRUCE, ROBERT NORWOOD (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:NORWOOD
Last Name:BRUCE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LRMC, CMR 402
Mailing Address - Street 2:BOX 100
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:314-486-7729
Mailing Address - Fax:
Practice Address - Street 1:CMR 402 BOX 100
Practice Address - Street 2:LRMC
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-0100
Practice Address - Country:US
Practice Address - Phone:314-486-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001318207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology