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Contact Information

BRUCE M LIDSTON, MD
1227 WARM SPRINGS AVE
J.C. BLAIR PHYSICIAN'S BUILDING #301
HUNTINGDON, PA16652-2300
 Phone: 814-643-0531
 Fax: 814-643-6637
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for BRUCE M LIDSTON · (Male)

NPI # 1407894173
Status Active
Credentials MD
Entity Individual
Enumeration date 06/03/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • PA License # MD016074E
  • PA Medicaid 000676816/0004
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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