Healthcare Provider Details

I. General information

NPI: 1306822424
Provider Name (Legal Business Name): JAMES DIMUZIO JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 JEFFERSON ST
WHITEVILLE NC
28472
US

IV. Provider business mailing address

333 JEFFERSON ST
WHITEVILLE NC
28472
US

V. Phone/Fax

Practice location:
  • Phone: 910-914-0540
  • Fax: 910-914-0640
Mailing address:
  • Phone: 910-914-0540
  • Fax: 910-914-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number9900207
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: