Basic Information
| Provider Information | |||||||||
| NPI: | 1902805724 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREENFIELD | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | MYRON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2024 SOUTH SIXTH STREET | ||||||||
| Address2: | BRAINERD MEDICAL CENTER | ||||||||
| City: | BRAINERD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2188282880 | ||||||||
| FaxNumber: | 2188287107 | ||||||||
| Practice Location | |||||||||
| Address1: | 2024 SOUTH SIXTH STREET | ||||||||
| Address2: | BRAINERD MEDICAL CENTER | ||||||||
| City: | BRAINERD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2188282880 | ||||||||
| FaxNumber: | 2188287107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2005 | ||||||||
| LastUpdateDate: | 10/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 73-125 | NM | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.