Provider Demographics
NPI:1215129432
Name:JAMES, ELDON (M AC, L AC)
Entity type:Individual
Prefix:MR
First Name:ELDON
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:M AC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 TWIN KNOLLS RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3257
Mailing Address - Country:US
Mailing Address - Phone:410-707-5363
Mailing Address - Fax:
Practice Address - Street 1:5401 TWIN KNOLLS RD
Practice Address - Street 2:SUITE 9
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3257
Practice Address - Country:US
Practice Address - Phone:410-707-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2007-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01528171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist