Healthcare Provider Details

I. General information

NPI: 1962039370
Provider Name (Legal Business Name): JAMES PATRICK WINEBRAKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3562 ANSLEY DR
WILMINGTON NC
28412-1219
US

IV. Provider business mailing address

3562 ANSLEY DR
WILMINGTON NC
28412-1219
US

V. Phone/Fax

Practice location:
  • Phone: 910-332-3560
  • Fax:
Mailing address:
  • Phone: 910-332-3560
  • Fax: 910-332-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number2026-00850
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: