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1710976634

NPI Code Detail

MEDICARE: BRUCE VOSS MD

MEDICARE: BRUCE VOSS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	40013	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710976634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE VOSS MD

Provider Business Mailing Address
First Line	:	PO BOX 36351
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28236-6351
Country	:	US
Telephone Number	:	704-377-5772
Fax Number	:	704-377-3389

Provider Business Practice Location Address
First Line	:	2001 VAIL AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28207-1219
Country	:	US
Telephone Number	:	704-379-5956
Fax Number	:	704-379-6218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	10/22/2007

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Directions to “ BRUCE VOSS MD” Practice Location

Language	Start Address	Practice Location

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