Provider Demographics
NPI:1326081142
Name:SEWARD, JAMES L (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:SEWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15830 BALLANTYNE MEDICAL PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4653
Mailing Address - Country:US
Mailing Address - Phone:704-341-0090
Mailing Address - Fax:704-341-0092
Practice Address - Street 1:15830 BALLANTYNE MEDICAL PL
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4653
Practice Address - Country:US
Practice Address - Phone:704-341-0090
Practice Address - Fax:704-341-0092
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200300408207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2014614Medicare ID - Type Unspecified
NCH84733Medicare UPIN