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NPI Code Detail

MEDICARE: MRS. JANE LUPTON BAHOR CCA/ANAPLASTOLOGIST

MEDICARE:  MRS. JANE LUPTON BAHOR  CCA/ANAPLASTOLOGIST
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
1229N00000XAnaplastologist

General Provider Information

NPI Number : 1164672036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANE LUPTON BAHOR CCA/ANAPLASTOLOGIST
Provider Business Mailing Address
First Line : 1911 HILLANDALE RD
Second Line : SUITE 1110
City : DURHAM
State : NC
Zip : 27705-2666
Country : US
Telephone Number : 919-383-1205
Fax Number : 919-383-2838
Provider Business Practice Location Address
First Line : 1911 HILLANDALE RD
Second Line : SUITE 1110
City : DURHAM
State : NC
Zip : 27705-2666
Country : US
Telephone Number : 919-383-1205
Fax Number : 919-383-2838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2008
Last Update Date : 09/26/2008

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Directions to “ MRS. JANE LUPTON BAHOR CCA/ANAPLASTOLOGIST” Practice Location

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