Provider Demographics
NPI:1942364955
Name:LEDERER, JAMES WEIL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WEIL
Last Name:LEDERER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2085 FRONTIS PLAZA BLVD
Mailing Address - Street 2:CLINICAL IMPROVEMENT DEPARTMENT
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5614
Mailing Address - Country:US
Mailing Address - Phone:336-277-1494
Mailing Address - Fax:336-277-1460
Practice Address - Street 1:2085 FRONTIS PLAZA BLVD
Practice Address - Street 2:CLINICAL IMPROVEMENT DEPARTMENT
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5614
Practice Address - Country:US
Practice Address - Phone:336-277-1494
Practice Address - Fax:336-277-1460
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC30878207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease