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General NPI Number Information
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NPI Number | 1053756577
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Entity Type | Individual
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Provider Name | JAMES RUSSELL BATEMAN III MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-0001
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Country | US
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Telephone | 336-716-2255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 780125
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0125
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Country | US
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Telephone | 804-922-4844
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 2018-01310
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2018-01310
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 0101284805
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License Number State | VA
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