Provider Demographics
NPI:1437937679
Name:SOLOMON, JAMES ALBERT
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALBERT
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E ARBOR AVE APT 108B
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5746
Mailing Address - Country:US
Mailing Address - Phone:701-498-9890
Mailing Address - Fax:
Practice Address - Street 1:215 E ARBOR AVE APT 108B
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5746
Practice Address - Country:US
Practice Address - Phone:701-498-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant