Basic Information
Provider Information
NPI: 1831654649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FELDMAN
FirstName: JAMES
MiddleName: HENRY
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1502 W NC HIGHWAY 54
Address2: STE 103
City: DURHAM
State: NC
PostalCode: 277075572
CountryCode: US
TelephoneNumber: 9194032122
FaxNumber:  
Practice Location
Address1: 3604 SHANNON RD STE 200
Address2:  
City: DURHAM
State: NC
PostalCode: 277076343
CountryCode: US
TelephoneNumber: 9194032122
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2019
LastUpdateDate: 03/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X0010-08849NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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