Provider Demographics
NPI:1447236781
Name:JAMES, SELINA L (MD)
Entity Type:Individual
Prefix:DR
First Name:SELINA
Middle Name:L
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 18563
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27619-8563
Mailing Address - Country:US
Mailing Address - Phone:919-781-9979
Mailing Address - Fax:919-781-0124
Practice Address - Street 1:3200 BLUE RIDGE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8086
Practice Address - Country:US
Practice Address - Phone:919-781-9979
Practice Address - Fax:919-781-0124
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9601350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911046Medicaid
NC2244734EMedicare PIN
NC2244734BMedicare PIN
NCF53378Medicare UPIN