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NPI Code Detail

MEDICARE: DR. JAMES GEORGE SCANLAN M.D.

MEDICARE:  DR. JAMES GEORGE SCANLAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician024289NC
2207RI0011XInterventional Cardiology Physician24289NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060000080OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962499087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES GEORGE SCANLAN M.D.
Provider Business Mailing Address
First Line : 4201 LAKE BOONE TRL STE 104
Second Line :
City : RALEIGH
State : NC
Zip : 27607-7511
Country : US
Telephone Number : 919-881-0160
Fax Number : 919-881-0887
Provider Business Practice Location Address
First Line : 4201 LAKE BOONE TRL
Second Line : SUITE 104
City : RALEIGH
State : NC
Zip : 27607-7512
Country : US
Telephone Number : 919-881-0160
Fax Number : 919-881-0887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 04/14/2021

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Directions to “ DR. JAMES GEORGE SCANLAN M.D.” Practice Location

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