Provider Demographics
NPI:1962602516
Name:POWERS, JAMES NICHOLS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NICHOLS
Last Name:POWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 WILLOUGHBY BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3164
Mailing Address - Country:US
Mailing Address - Phone:843-492-7298
Mailing Address - Fax:
Practice Address - Street 1:618 WILLOUGHBY BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3164
Practice Address - Country:US
Practice Address - Phone:843-492-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC31695207RI0200X
WI83633207RI0200X
NC2020-00240207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC316955Medicaid
SCAA38134744Medicare PIN