Bruce M. Bilder, M.D.

Individual provider Active NPI Emergency Medicine Physician · San Carlos, AZ

NPI 1306955596 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1306955596
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
MD018668E (PA)
Practice address
223 Cibeque Circle Road
San Carlos, AZ 85550
Phone
(928) 475-7219
Fax
(928) 475-7370
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD018668EPAMDEmergency Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD018668E PA Yes

Addresses

Primary practice location

223 Cibeque Circle Road
San Carlos, AZ 85550

Mailing address

PO Box 208
San Carlos, AZ 85550-0208
Phone (928) 475-7219

Other identifiers

IdentifierTypeStateIssuer
811639MedicaidAZ

Other providers in San Carlos, AZ

All providers in San Carlos, AZ · Emergency Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.