1801090022 NPI number — JAMES G TELFER JR MD PA

Table of content: (NPI 1801090022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801090022 NPI number — JAMES G TELFER JR MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES G TELFER JR MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1801090022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 S ACADEMY ST
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-467-7528
Provider Business Mailing Address Fax Number:
919-467-1855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 JOSEFA WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95060-2984
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-218-4601
Provider Business Practice Location Address Fax Number:
919-467-1855
Provider Enumeration Date:
06/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TELFER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-467-7528

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  21445 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8982348 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com