Provider Demographics
NPI:1659351161
Name:SROUR, JAMES W (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:SROUR
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 1:2690 SOUTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4510
Mailing Address - Country:US
Mailing Address - Phone:717-741-1414
Mailing Address - Fax:717-741-4774
Practice Address - Street 1:2690 SOUTHFIELD DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4510
Practice Address - Country:US
Practice Address - Phone:717-741-1414
Practice Address - Fax:717-741-4774
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-021267-E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0881290101Medicaid
PA0881290101Medicaid
PAB37107Medicare UPIN