Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101249719 | VA |
Y | 2080P0210X | Pediatric Nephrologist | 0101249719 | VA |
NPI | 1598927030 |
---|---|
Provider Name | Dr. James B Carmody |
First Address | Norfolk, VA 23507-1910 |
Second Address | Norfolk, VA 23507-1910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 18/02/2019 |