Provider Demographics
NPI:1154387199
Name:BRUCE, JOEL E (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
Last Name:BRUCE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3158 FREEDOM DR STE 3102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-0014
Mailing Address - Country:US
Mailing Address - Phone:704-971-7099
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:3033 EASTWAY DR STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6387
Practice Address - Country:US
Practice Address - Phone:704-731-6451
Practice Address - Fax:704-731-6452
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043650L207RN0300X
NC96-00877207RN0300X
SC19412207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20301OtherPARTNERS
NC276910OtherMAMSI
NC561550231KOtherCIGNA
SCN00877Medicaid
NC390004610OtherRR MEDICARE
NC8919287Medicaid
NC19287OtherBCBSNC
NCG21577Medicare UPIN
SCN00877Medicaid