Provider Demographics
NPI:1194775098
Name:ISRAEL, BRUCE FREDERICK (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:FREDERICK
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 S FRENCH BROAD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3272
Mailing Address - Country:US
Mailing Address - Phone:828-258-9635
Mailing Address - Fax:828-258-9682
Practice Address - Street 1:53 S FRENCH BROAD AVE
Practice Address - Street 2:STE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3272
Practice Address - Country:US
Practice Address - Phone:828-258-9635
Practice Address - Fax:828-258-9682
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800916207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1202VOtherBCBS
NC891202VMedicaid
NC2282730Medicare ID - Type Unspecified
NC1202VOtherBCBS