1407897325 NPI number — DR. EVITA G JAMES M.D., F.A.C.O.G.

Table of content: DR. EVITA G JAMES M.D., F.A.C.O.G. (NPI 1407897325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407897325 NPI number — DR. EVITA G JAMES M.D., F.A.C.O.G.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAMES
Provider First Name:
EVITA
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., F.A.C.O.G.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407897325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7411 RIGGS RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
ADELPHI
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20783-4246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-440-7765
Provider Business Mailing Address Fax Number:
301-445-2894

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7411 RIGGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYATTSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20783-4246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-408-2799
Provider Business Practice Location Address Fax Number:
301-445-2894
Provider Enumeration Date:
06/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0043863 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 405954900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120271500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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