Provider Demographics
NPI:1992025548
Name:BRUCE, NATALIE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ANN
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:ANN
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:940 SE CARY PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518
Mailing Address - Country:US
Mailing Address - Phone:919-859-9991
Mailing Address - Fax:919-859-6595
Practice Address - Street 1:940 SE CARY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7417
Practice Address - Country:US
Practice Address - Phone:919-859-9991
Practice Address - Fax:919-859-6595
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-06
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-00638208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901102Medicaid