MEDICARE: DR. JAMES CORNELIUS WOMBLE MD

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	208000000X	Pediatrics Physician	38885	NC
2	207R00000X	Internal Medicine Physician	0038885	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447256748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CORNELIUS WOMBLE MD

Provider Business Mailing Address
First Line	:	224 HIGH HOUSE RD
Second Line	:	STE 100
City	:	CARY
State	:	NC
Zip	:	27513-4278
Country	:	US
Telephone Number	:	919-380-7531
Fax Number	:	919-380-0686

Provider Business Practice Location Address
First Line	:	224 HIGH HOUSE RD
Second Line	:	STE 100
City	:	CARY
State	:	NC
Zip	:	27513-4278
Country	:	US
Telephone Number	:	919-380-7531
Fax Number	:	919-380-0686

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	05/18/2022

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