Provider Demographics
NPI:1376519058
Name:CAMPBELL, JAMES STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEWART
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3705 SAPONA TRL
Mailing Address - Street 2:
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-9427
Mailing Address - Country:US
Mailing Address - Phone:336-945-4546
Mailing Address - Fax:336-945-2498
Practice Address - Street 1:3705 SAPONA TRL
Practice Address - Street 2:
Practice Address - City:PFAFFTOWN
Practice Address - State:NC
Practice Address - Zip Code:27040-9427
Practice Address - Country:US
Practice Address - Phone:336-945-4546
Practice Address - Fax:336-945-2498
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20380207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C80815Medicare UPIN