Provider Demographics
NPI:1124312145
Name:STEPHEN, JAMES HARRIS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HARRIS
Last Name:STEPHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:851 MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1612
Mailing Address - Country:US
Mailing Address - Phone:617-525-8309
Mailing Address - Fax:617-713-3050
Practice Address - Street 1:851 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1612
Practice Address - Country:US
Practice Address - Phone:175-258-3096
Practice Address - Fax:617-713-3050
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451911207T00000X
PAMT200252207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery