Provider Demographics
NPI:1952348146
Name:ANDERSON, JAMES COCHRAN IV (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:COCHRAN
Last Name:ANDERSON
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:4515 PREMIER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8357
Practice Address - Country:US
Practice Address - Phone:336-802-2200
Practice Address - Fax:336-802-2201
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2013-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC97-00451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891033UMedicaid
G47427Medicare UPIN
NC891033UMedicaid