MEDICARE: DR. BRUCE LINCOLN DOWNES M.D

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	207R00000X	Internal Medicine Physician	2005-01720	NC
2	208M00000X	Hospitalist Physician	2005-01720	NC

General Provider Information

NPI Number	:	1932244878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE LINCOLN DOWNES M.D

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-384-5416
Fax Number	:	704-384-5992

Provider Business Practice Location Address
First Line	:	8201 HEALTHCARE LOOP STE 305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-7072
Country	:	US
Telephone Number	:	980-302-3050
Fax Number	:	980-302-3055

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	10/25/2020

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