Andersen, Bruce A
Andersen, Bruce A is an individual health care provider with primary practice located at 109 Railroad Ave , Las Vegas NM 87701. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Andersen, Bruce A can be contacted via phone (505) 425-9491.Contact Information
Primary practice address
109 Railroad Ave
Las Vegas NM 87701
Phone: (505) 425-9491
Fax: (505) 454-8171
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 163 | New Mexico |
Profile Details
| NPI number | 1609960699 |
|---|---|
| LBN Legal business name | Andersen, Bruce A |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | May 7th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609960699 | NPPES |
| Other | 005351 | BCBS | |
| Other | 10478 | BCBS |
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