MEDICARE: DR. ISRAEL LANDA 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	207P00000X	Emergency Medicine Physician	0101282809	VA
2	207P00000X	Emergency Medicine Physician	33170	WV
3	207P00000X	Emergency Medicine Physician	MD430239	PA
4	207P00000X	Emergency Medicine Physician	49746	KY
5	207P00000X	Emergency Medicine Physician	201300437	NC
6	207P00000X	Emergency Medicine Physician	059817	GA
7	207P00000X	Emergency Medicine Physician	336.079381	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	201300437	OTHER	NC	NC MEDICAL LICENSE

General Provider Information

NPI Number	:	1255536165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISRAEL LANDA M.D

Provider Business Mailing Address
First Line	:	6300 CASS HOLT RD
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-9759
Country	:	US
Telephone Number	:	312-420-4878
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 WAYNE MEMORIAL DRIVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-731-6060
Fax Number	:	919-731-6534

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	06/05/2026

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Directions to “ DR. ISRAEL LANDA M.D” Practice Location

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