Provider Demographics
NPI:1548263205
Name:TOPOROFF, BRUCE MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:MICHAEL
Last Name:TOPOROFF
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:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4785
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:10001 S EASTERN AVE STE 201
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3908
Practice Address - Country:US
Practice Address - Phone:702-616-5700
Practice Address - Fax:702-982-6347
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV23856208G00000X
NY166253-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
780002123OtherRAILROAD MEDICARE
CAGR0087650Medicaid
CAZZZ07779ZOtherBLUE SHIELD
CAWG86325BMedicare PIN
CAZZZ07779ZOtherBLUE SHIELD
CAWG86325AMedicare PIN