Provider Demographics
NPI:1902885700
Name:BLAIR, JAMES S III (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:BLAIR
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:13567 NC HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:SURF CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28445-6555
Mailing Address - Country:US
Mailing Address - Phone:910-329-9916
Mailing Address - Fax:910-329-9919
Practice Address - Street 1:13567 NC HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445-6555
Practice Address - Country:US
Practice Address - Phone:910-329-9916
Practice Address - Fax:910-329-9919
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2013-07-16
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Provider Licenses
StateLicense IDTaxonomies
NC32636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8916154Medicaid
NCE55731Medicare UPIN
NC8916154Medicaid
2153278HMedicare ID - Type Unspecified