MEDICARE: DR. JAMES A SCOVIL 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	173000000X	Legal Medicine	17431	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	75078	OTHER	NC	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386648756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES A SCOVIL M.D.

Provider Business Mailing Address
First Line	:	23 SUNNYBROOK RD
Second Line	:	STE 109
City	:	RALEIGH
State	:	NC
Zip	:	27610-1855
Country	:	US
Telephone Number	:	919-212-1959
Fax Number	:	919-212-1989

Provider Business Practice Location Address
First Line	:	23 SUNNYBROOK RD
Second Line	:	STE 109
City	:	RALEIGH
State	:	NC
Zip	:	27610-1855
Country	:	US
Telephone Number	:	919-212-1959
Fax Number	:	919-212-1989

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/08/2007

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