Provider Demographics
NPI:1124065826
Name:SMITH, BRUCE W (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:42 ASBURY ST
Mailing Address - Street 2:
Mailing Address - City:S HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1808
Mailing Address - Country:US
Mailing Address - Phone:978-468-4101
Mailing Address - Fax:978-468-7067
Practice Address - Street 1:42 ASBURY ST
Practice Address - Street 2:PATTON PARK MED.CENTER
Practice Address - City:S HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1808
Practice Address - Country:US
Practice Address - Phone:978-468-4101
Practice Address - Fax:978-468-7067
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2015-07-22
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Provider Licenses
StateLicense IDTaxonomies
MA70411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine