Provider Demographics
NPI:1639190234
Name:WHINNA, JAMES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:WHINNA
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 601888
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1888
Mailing Address - Country:US
Mailing Address - Phone:704-289-3024
Mailing Address - Fax:704-226-1236
Practice Address - Street 1:1550 FAULK ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5086
Practice Address - Country:US
Practice Address - Phone:704-289-3024
Practice Address - Fax:704-226-1236
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26481208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN26481Medicaid
NC1639190234Medicaid
NC8986906Medicaid
NCC87115Medicare UPIN
NC8986906Medicaid
NC211466AMedicare PIN
NCNC9490AMedicare PIN