Provider Demographics
NPI:1114971272
Name:BRUIN, STEVEN J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:BRUIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1431 BEAM AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1064
Mailing Address - Country:US
Mailing Address - Phone:651-486-1747
Mailing Address - Fax:651-486-1744
Practice Address - Street 1:1431 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1064
Practice Address - Country:US
Practice Address - Phone:651-486-1747
Practice Address - Fax:651-486-1744
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118264-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist