Basic Information
Provider Information
NPI: 1225001407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRIS
FirstName: JAMES
MiddleName: V
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 E MOREHEAD ST
Address2: STE 300
City: CHARLOTTE
State: NC
PostalCode: 282022788
CountryCode: US
TelephoneNumber: 7043347800
FaxNumber: 7044147512
Practice Location
Address1: 700 E MOREHEAD ST
Address2: STE 300
City: CHARLOTTE
State: NC
PostalCode: 282022788
CountryCode: US
TelephoneNumber: 7043347800
FaxNumber: 7044147512
Other Information
ProviderEnumerationDate: 02/09/2006
LastUpdateDate: 12/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X36695SCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD050109LPAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X2014-00038NCY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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