Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101229130 | VA |
NPI | 1366458283 |
---|---|
Provider Name | James Marc Cardelia |
First Address | Atlanta, GA 30374-1593 |
Second Address | Norfolk, VA 23502-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 11/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006712991 | (05) | VA |
006712991 | VA PREMIER (01) | VA |
283177 | ALLIANCE/MDIPA (01) | VA |
283177 | MAMSI/OPTIMUM CHOICE (01) | VA |
29771 | OPTIMA/SENTARA HEALTH (01) | VA |
311610834 | NC HEALTH CHOICE (01) | VA |
3116108340005E | CIGNA (01) | VA |
4397279 | AETNA (01) | VA |
452226 | ANTHEM BCBS (01) | VA |
89063PG | NORTH CAROLINA MEDICAID (01) | VA |
G47212 | (02) | VA |
G47212 | BEECH STREET (01) | VA |