Provider Demographics
NPI:1184679441
Name:ARD, JAMY D (MD)
Entity Type:Individual
Prefix:
First Name:JAMY
Middle Name:D
Last Name:ARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 602658
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2658
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-6637
Practice Address - Street 1:4614 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3520
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:336-716-6637
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2001-0637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00103970OtherRAILROAD MEDICARE
NC89129VJMedicaid
AL051553745Medicaid
NCNC8134AMedicare UPIN