Provider Demographics
NPI:1669470191
Name:USHER, BRUCE WARREN JR (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:WARREN
Last Name:USHER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1505 SW CARY PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6219
Mailing Address - Country:US
Mailing Address - Phone:919-387-3260
Mailing Address - Fax:919-367-2617
Practice Address - Street 1:300 ASHVILLE AVE
Practice Address - Street 2:301
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8682
Practice Address - Country:US
Practice Address - Phone:919-851-6901
Practice Address - Fax:919-851-9354
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2021-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200000647207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-12656Medicaid
NC2279986Medicare PIN
NC89-12656Medicaid