DR. BRUCE JAMES MACK M.D. NPI 1013958339

NPI Information

NPI: 1013958339
Provider Name: DR. BRUCE JAMES MACK, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Address:
4225 GOLDEN VALLEY RD
GOLDEN VALLEY, MN
ZIP 55422
Phone: (763) 588-0661
Get Directions

DR. Bruce James Mack, M.D. is a neurology psychiatry neurology in Golden Valley, MN. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Bruce James Mack, M.D. NPI is 1013958339. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4225 GOLDEN VALLEY RD
GOLDEN VALLEY, MN
ZIP 55422-215
Phone: (763) 588-0661
Fax: (763) 287-2310

The enumeration date for this NPI number is 6/9/2006 and was last updated on 7/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	40493	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C08477	MEDICARE UPIN	MINNESOTA
2	35Q98MA	OTHER	MINNESOTA	BCBS OF MN
3	769546	OTHER	MINNESOTA	AMERICA'S PPO
4	0500046	OTHER	MINNESOTA	MEDICA
5	1015838	OTHER	MINNESOTA	PREFERRED ONE
6	32438000	MEDICAID	WISCONSIN
7	HP24316	OTHER	MINNESOTA	HEALTHPARTNERS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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