MEDICARE: JAMES JAY ESBENSHADE M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD069937L	PA

General Provider Information

NPI Number	:	1134140015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES JAY ESBENSHADE M.D.

Provider Business Mailing Address
First Line	:	5000 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-9263
Country	:	US
Telephone Number	:	804-968-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2310 SCHOENERSVILLE RD
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-3602
Country	:	US
Telephone Number	:	484-403-7560
Fax Number	:	484-403-7561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	06/16/2021

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