Provider Demographics
NPI:1285671115
Name:DRUKKER, BRUCE H (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:H
Last Name:DRUKKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:890 W FARIS RD
Practice Address - Street 2:SUITE 470
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4247
Practice Address - Country:US
Practice Address - Phone:864-455-1600
Practice Address - Fax:864-455-3095
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC18973207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC189735Medicaid
SC576007863107OtherBCBS OF SC
SC160057952OtherRR MEDICARE
SC7548491OtherAETNA
SC0584313OtherCIGNA
SC576007863029OtherBLUE CHOICE OF SC
SCB44031Medicare UPIN
SC576007863107OtherBCBS OF SC
SCB440313640Medicare PIN