Provider Demographics
NPI:1801090022
Name:JAMES G TELFER JR MD PA
Entity type:Organization
Organization Name:JAMES G TELFER JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:TELFER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-467-7528
Mailing Address - Street 1:305 S ACADEMY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-467-7528
Mailing Address - Fax:919-467-1855
Practice Address - Street 1:18 JOSEFA WAY
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2984
Practice Address - Country:US
Practice Address - Phone:919-218-4601
Practice Address - Fax:919-467-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21445207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8982348Medicaid
C80925Medicare UPIN
NC230822Medicare PIN