Fawcett, Bruce G
Fawcett, Bruce G is an sole proprietor health care provider with primary practice located at 1514 Glenwood Ave , Raleigh NC 27608-2368. He recently has 6 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Public Medicine, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Fawcett, Bruce G can be contacted via phone (919) 829-0076.Contact Information
Primary practice address
1514 Glenwood Ave
Raleigh NC 27608-2368
Phone: (919) 829-0076
Fax: (919) 836-9094
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 154 | North Carolina |
| Podiatric Medicine & Surgery Service Providers / Public Medicine | 213EP0504X | 154 | North Carolina |
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 154 | North Carolina |
| Podiatric Medicine & Surgery Service Providers / Radiology | 213ER0200X | 154 | North Carolina |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | 154 | North Carolina |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 154 | North Carolina |
Profile Details
| NPI number | 1336238336 |
|---|---|
| LBN Legal business name | Fawcett, Bruce G |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Apr 4th, 2016 - about 8 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 | 1336238336 | NPPES |
| North Carolina | Other | 2751610 | UNITED |
| North Carolina | Other | 08064 | UNITED |
| North Carolina | Other | 1115086015 | UNITED |
| North Carolina | Other | 480017899 | UNITED |
| North Carolina | MEDICAID | 7908064 | UNITED |
| North Carolina | Other | 16437 | UNITED |
| North Carolina | Other | 561412156 | UNITED |
| North Carolina | Other | 4279205 | UNITED |
| North Carolina | Other | 440912 | UNITED |
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