Mathern, Bruce E
Mathern, Bruce E is an individual health care provider with primary practice located at 417 N 11Th St , Richmond VA 23298-5002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Mathern, Bruce E can be contacted via phone (804) 828-9165.Contact Information
Primary practice address
417 N 11Th St
Richmond VA 23298-5002
Phone: (804) 828-9165
Fax: (804) 828-0374
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 0101052126 | Virginia |
Profile Details
| NPI number | 1518903491 |
|---|---|
| LBN Legal business name | Mathern, Bruce E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Jul 9th, 2007 - 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 | 1518903491 | NPPES |
| Virginia | MEDICAID | 6103456 - 541581185 | |
| Virginia | Other | 490032CG09729 |
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