Bruce L Larva, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301038611 Issued in MI

Practice address

3434 Celina Ave
Saint Joseph, MI 49085-3711

Phone

(269) 429-7225

NPI assigned

Oct 14, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1720398563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NILES AVE",
            "address_2": "SUITE 101",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851615",
            "telephone_number": "269-983-0929",
            "fax_number": "269-983-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 CELINA AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853711",
            "telephone_number": "269-429-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARVA",
        "first_name": "BRUCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301038611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.