Provider Demographics
NPI:1750685244
Name:MCBRYDE, JAMES ANTHONY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANTHONY
Last Name:MCBRYDE
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 602458
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2458
Mailing Address - Country:US
Mailing Address - Phone:910-277-9164
Mailing Address - Fax:910-277-9189
Practice Address - Street 1:1600 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5524
Practice Address - Country:US
Practice Address - Phone:910-277-9164
Practice Address - Fax:910-277-9189
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2016-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-02673363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1845PAMedicaid
NC1750685244Medicaid
SC1845PAMedicaid
NCNC2779EMedicare PIN