Provider Demographics
NPI:1538784855
Name:BRUCE, ANDREW LLOYD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LLOYD
Last Name:BRUCE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 BRUSH ST APT 1403
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-4332
Mailing Address - Country:US
Mailing Address - Phone:810-265-6331
Mailing Address - Fax:
Practice Address - Street 1:8463 FLETCHER RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8908
Practice Address - Country:US
Practice Address - Phone:810-265-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist