Provider Demographics
NPI:1124026695
Name:MANN, JAMES TIFT III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TIFT
Last Name:MANN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:G-100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1231
Mailing Address - Country:US
Mailing Address - Phone:919-231-8253
Mailing Address - Fax:919-231-9546
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:G-100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-231-8253
Practice Address - Fax:919-231-9546
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2011-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC16417207RI0011X, 207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-53885Medicaid
NCC87561Medicare UPIN
NC208477HMedicare PIN