MEDICARE: JOHN DOUGLAS DOTY II 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	207R00000X	Internal Medicine Physician	2007-01291	NC
2	207RP1001X	Pulmonary Disease Physician	2007-01291	NC
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2007-01291	NC

General Provider Information

NPI Number	:	1992786081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN DOUGLAS DOTY II MD

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 HARDING PL
Second Line	:	STE 3200
City	:	CHARLOTTE
State	:	NC
Zip	:	28204
Country	:	US
Telephone Number	:	704-355-5375
Fax Number	:

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	07/24/2024

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