Provider Demographics
NPI:1457585382
Name:PEDRAZA, JAIME (MD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:PEDRAZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:# 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-781-5600
Mailing Address - Fax:919-863-6821
Practice Address - Street 1:7750 MCCRIMMON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1912
Practice Address - Country:US
Practice Address - Phone:919-234-1577
Practice Address - Fax:919-235-0569
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2021-03-25
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Provider Licenses
StateLicense IDTaxonomies
NC201301532207Q00000X
NC2013-05132207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine