Provider Demographics
NPI:1912264839
Name:JAMES G JOACHIM M D P C
Entity Type:Organization
Organization Name:JAMES G JOACHIM M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GOLDEN
Authorized Official - Last Name:JOACHIM
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:910-762-8077
Mailing Address - Street 1:1602 PHYSICIANS DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7363
Mailing Address - Country:US
Mailing Address - Phone:910-762-8077
Mailing Address - Fax:910-762-2760
Practice Address - Street 1:1602 PHYSICIANS DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7363
Practice Address - Country:US
Practice Address - Phone:910-762-8077
Practice Address - Fax:910-762-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2204428AMedicare PIN
NCA29756Medicare UPIN