Individual
DR. BRUCE S MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 CORPORATE PARK DR, SUITE 200 & 300, MOORESVILLE, NC 28117-7134
(704) 235-9090
(704) 235-9101
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9600630
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89128YU
—
NC
Enumeration date
01/09/2006
Last updated
10/28/2020
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