Doctor Name: | BRUCE KENT WINNER |
NPI Number: | 1285734459 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | BW057232 |
Business Practice Address: | 680 W Columbia Ave Battle Creek, MI - 490153028 |
Business Phone Number: | 2699654500 |
Business Fax Number: | 2699651150 |
Mailing Address: | 601 John St, Box 42 KALAMAZOO |
State: | MI |
Postal Code: | 490075341 |
Phone Number: | 2693417806 |
Fax Number: | 2693418743 |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 08/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | BW057232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |