Provider Demographics
NPI:1578536967
Name:CARRAWAY, JAMES HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HOWARD
Last Name:CARRAWAY
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-557-0300
Mailing Address - Fax:757-557-0321
Practice Address - Street 1:5589 GREENWICH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6565
Practice Address - Country:US
Practice Address - Phone:757-557-0300
Practice Address - Fax:757-557-0321
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101015813208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006923909Medicaid
VA099584OtherANTHEM
NC05415OtherNC BC/BS
VAPAROtherCORVEL/CORCARE
VAPAROtherUSA MANAGED CARE
NC6905415Medicaid
VAPAROtherCORVEL/CORCARE
VAB62029Medicare UPIN
VA240005581Medicare PIN