Dr. Bruce James Mack
Neurologist
4225 Golden Valley Rd
Golden Valley
, Minnesota 55422-4215
Dr. Bruce James Mack
Neurologist
4225 Golden Valley Rd
Golden Valley
, Minnesota 55422-4215
(763) 287-2310
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Dr. Bruce James Mack
- 4225 Golden Valley Rd
- Golden Valley, MN
- Zip : 55422-4215
- Fax : (763) 287-2310
- Phone : (763) 588-0661
Second Address
- Dr. Bruce James Mack
- 4225 Golden Valley Rd
- Golden Valley, MN
- Zip : 55422-4215
- Fax : (763) 287-2310
- Phone : (763) 588-0661
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 40493 | MN |
National Provider Identifier
| NPI | 1013958339 |
|---|---|
| Provider Name | Dr. Bruce James Mack |
| First Address | Golden Valley, MN 55422-4215 |
| Second Address | Golden Valley, MN 55422-4215 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2006 |
| Last Update Date | 11/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0500046 | MEDICA (01) | MN |
| 1015838 | PREFERRED ONE (01) | MN |
| 32438000 | (05) | WI |
| 35Q98MA | BCBS OF MN (01) | MN |
| 769546 | AMERICA'S PPO (01) | MN |
| C08477 | (02) | MN |
| HP24316 | HEALTHPARTNERS (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.