Provider Demographics
NPI:1033272810
Name:BURNS, BRUCE ELLIOTT (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:ELLIOTT
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 411 BOX 6422
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-0065
Mailing Address - Country:US
Mailing Address - Phone:011-496-3719
Mailing Address - Fax:
Practice Address - Street 1:MEDDAC-BAVARIA PSC 411
Practice Address - Street 2:UNIT 28037
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112-8037
Practice Address - Country:US
Practice Address - Phone:314-590-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA490642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry