Healthcare Provider Details

I. General information

NPI: 1366496382
Provider Name (Legal Business Name): JAMES PETER MANOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 JONES FERRY RD STE 102
CARRBORO NC
27510-6113
US

IV. Provider business mailing address

1021 DARRINGTON DR STE 101
CARY NC
27513-8158
US

V. Phone/Fax

Practice location:
  • Phone: 919-929-1747
  • Fax: 919-933-5168
Mailing address:
  • Phone: 919-852-3999
  • Fax: 919-378-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25815
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: