Provider Demographics
NPI:1427407923
Name:JAMES, DYLAN (MSED)
Entity Type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 E SERGEANT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1318
Mailing Address - Country:US
Mailing Address - Phone:215-370-2628
Mailing Address - Fax:
Practice Address - Street 1:3231 S GULLEY RD STE E
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4407
Practice Address - Country:US
Practice Address - Phone:313-300-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management