MEDICARE: JAMES MAZUR DPM PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	335E00000X	Prosthetic/Orthotic Supplier
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	480025840	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4306	OTHER	NC	PARTNERS
2	0803T	OTHER	NC	BCBS OF NC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0396450001	OTHER	NC	TRICARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063527794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES MAZUR DPM PA

Provider Business Mailing Address
First Line	:	322 MOCKSVILLE AVE
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28144-3328
Country	:	US
Telephone Number	:	704-636-7015
Fax Number	:	704-636-9788

Provider Business Practice Location Address
First Line	:	322 MOCKSVILLE AVE
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28144-3328
Country	:	US
Telephone Number	:	704-636-7015
Fax Number	:	704-636-9788

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES MAZUR
Credential	:	DPM
Telephone Number	:	704-636-7015

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	02/23/2013

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Directions to “JAMES MAZUR DPM PA ” Practice Location

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