Basic Information
Provider Information
NPI: 1932244878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWNES
FirstName: BRUCE
MiddleName: LINCOLN
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 60447
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282600447
CountryCode: US
TelephoneNumber: 7043845416
FaxNumber: 7043845992
Practice Location
Address1: 8201 HEALTHCARE LOOP STE 305
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282157072
CountryCode: US
TelephoneNumber: 9803023050
FaxNumber: 9803023055
Other Information
ProviderEnumerationDate: 02/20/2007
LastUpdateDate: 10/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2005-01720NCN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X2005-01720NCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home