Lidston, Bruce Malcom

Lidston, Bruce Malcom is an individual health care provider with primary practice located at 1227 Warm Springs Ave J.C. Blair Physician'S Building #301, Huntingdon PA 16652-2300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Lidston, Bruce Malcom can be contacted via phone (814) 643-0531.

Contact Information

Primary practice address
1227 Warm Springs Ave J.C. Blair Physician'S Building #301 Huntingdon PA 16652-2300
Phone: (814) 643-0531
Fax: (814) 643-6637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MD016074E Pennsylvania

Profile Details

NPI number 1407894173
LBN Legal business name Lidston, Bruce Malcom
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407894173 NPPES
Pennsylvania MEDICAID 000676816/0004

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