Healthcare Provider Details

I. General information

NPI: 1437150851
Provider Name (Legal Business Name): JAMES MICHAEL STARR EMT - P
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805B LAS VEGAS CT
LAS CRUCES NM
88007-4164
US

IV. Provider business mailing address

PO BOX 674
WILLIAMSBURG NM
87942-0674
US

V. Phone/Fax

Practice location:
  • Phone: 505-527-2166
  • Fax:
Mailing address:
  • Phone: 505-894-4377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number17134
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: