Provider Demographics
NPI:1831198563
Name:WORTMAN, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:WORTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1902 MEETING CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6631
Mailing Address - Country:US
Mailing Address - Phone:910-251-0811
Mailing Address - Fax:910-762-3587
Practice Address - Street 1:1902 MEETING CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6631
Practice Address - Country:US
Practice Address - Phone:910-251-0811
Practice Address - Fax:910-762-3587
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2011-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC22995207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0428849OtherUNITED HEALTHCARE
NC2070622OtherFIRST HEALTH NETWORK
NC891308XMedicaid
NC1308XOtherBCBS OF NC
NC561660283Y1OtherCIGNA
NC561660283OtherSOUTHCARE PPO
NC561660283OtherHEALTH CARE SAVINGS
NC561660283OtherAETNA
NC32968OtherMEDCOST
NC439336OtherMAMSI
NC439336OtherMAMSI
NCC87291Medicare UPIN
NC32968OtherMEDCOST