Individual provider · NPI-1

Adam W Bruckner, D.O.

Family Medicine · Aiken, SC

NPI number1316109564
StatusActive
Last updated in NPPESFeb 23, 2019

Details

NPI
1316109564
Entity type
Individual (NPI-1)
Name
Adam W Bruckner
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2008
Last updated
Feb 23, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine1639SCYes

Practice location

420 Society Hill Dr
Suite 200
Aiken, SC 29803-1731

Phone 803-649-7266 · Fax 803-649-7158

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King Of Prussia, PA 19406-3121

Phone 803-649-7266

Other practice locations

110 Sasanqua Drive
Graniteville, SC 29829-4136

Phone 803-392-1811 · Fax 803-761-6247

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