Provider Demographics
NPI:1063430684
Name:JAMES, KURISUMMOOTIL SEBASTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:KURISUMMOOTIL
Middle Name:SEBASTIAN
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4031 PLANTATION DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655
Mailing Address - Country:US
Mailing Address - Phone:828-584-9570
Mailing Address - Fax:
Practice Address - Street 1:1000 SOUTH STERLING STREET
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3999
Practice Address - Country:US
Practice Address - Phone:828-433-2567
Practice Address - Fax:828-433-2242
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97017752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF55538Medicare UPIN