Healthcare Provider Details

I. General information

NPI: 1649250580
Provider Name (Legal Business Name): BRUCE B LUDWIG JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 ALCOA HWY SUITE E-210
KNOXVILLE TN
37920-2244
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-7471
  • Fax: 865-305-6563
Mailing address:
  • Phone: 410-933-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number42434
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number42434
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0079147
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: