Provider Demographics
NPI:1346403052
Name:JAMES, NICHOLAS C (DO)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:C
Last Name:JAMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-781-2799
Mailing Address - Fax:772-781-2716
Practice Address - Street 1:3801 S KANNER HWY STE 300
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4801
Practice Address - Country:US
Practice Address - Phone:772-223-4978
Practice Address - Fax:772-223-2847
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS15500207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100545800Medicaid
FLF17S2OtherFLORIDA BLUE