Individual provider · NPI-1

Bruce Bart Berry, M.D.

Internal Medicine · Waukesha, WI

NPI number1710065230
StatusActive
Last updated in NPPESApr 1, 2019

Details

NPI
1710065230
Entity type
Individual (NPI-1)
Name
Mr. Bruce Bart Berry
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Nov 1, 2006
Last updated
Apr 1, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine25901WIYes

Practice location

2315 E Moreland Blvd
Waukesha, WI 53186-2939

Phone 262-532-5700 · Fax 262-532-5701

Mailing address

2315 E Moreland Blvd
Waukesha, WI 53186-2939

Phone 262-532-5700 · Fax 262-532-5701

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