MEDICARE: JAMES MICHAEL STARR EMT - P

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	146L00000X	Paramedic	17134	NM

General Provider Information

NPI Number	:	1437150851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES MICHAEL STARR EMT - P

Provider Business Mailing Address
First Line	:	PO BOX 674
Second Line	:
City	:	WILLIAMSBURG
State	:	NM
Zip	:	87942-0674
Country	:	US
Telephone Number	:	505-894-4377
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805B LAS VEGAS CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-4164
Country	:	US
Telephone Number	:	505-527-2166
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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