Provider Demographics
NPI:1235129081
Name:DEORIO, JAMES KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEITH
Last Name:DEORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4709 CREEKSTONE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8411
Mailing Address - Country:US
Mailing Address - Phone:919-660-2358
Mailing Address - Fax:919-660-8568
Practice Address - Street 1:4709 CREEKSTONE DR STE 200
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8411
Practice Address - Country:US
Practice Address - Phone:919-660-2358
Practice Address - Fax:919-660-8568
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47550207X00000X
NC2007--00102207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL700005983OtherRAILROAD MEDICARE
NC5906154Medicaid
FL02098OtherBLUECROSS/BLUESHIELD
FL260189700Medicaid
FL260189700Medicaid
NC2064105Medicare PIN