Provider Demographics
NPI:1508823162
Name:UMESI, JOSEPH JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JACK
Last Name:UMESI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MEDICAL CENTER ROAD
Mailing Address - Street 2:
Mailing Address - City:MAMERS
Mailing Address - State:NC
Mailing Address - Zip Code:27552
Mailing Address - Country:US
Mailing Address - Phone:910-893-5402
Mailing Address - Fax:910-893-2567
Practice Address - Street 1:1000 MEDICAL CENTER ROAD
Practice Address - Street 2:
Practice Address - City:MAMERS
Practice Address - State:NC
Practice Address - Zip Code:27552
Practice Address - Country:US
Practice Address - Phone:910-893-5402
Practice Address - Fax:910-893-2567
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137K9Medicaid
NC89137K9Medicaid
2030720Medicare ID - Type Unspecified