Healthcare Provider Details

I. General information

NPI: 1427010834
Provider Name (Legal Business Name): JAMES STUART MCGRATH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 08/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 W MAIN ST
YADKINVILLE NC
27055-7804
US

IV. Provider business mailing address

PO BOX 189
YADKINVILLE NC
27055-0189
US

V. Phone/Fax

Practice location:
  • Phone: 336-679-6758
  • Fax: 336-679-6744
Mailing address:
  • Phone: 336-677-1100
  • Fax: 336-677-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25818
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: