Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 221849 | NY |
Y | 111NI0900X | Internist | 221849 | NY |
N | 207R00000X | Internist | 36606 | SC |
N | 111NI0900X | Internist | 36606 | SC |
N | 207RA0401X | Internist - Addiction Medicine | 2012522 | NY |
NPI | 1912008806 |
---|---|
Provider Name | James Winbush |
First Address | Anderson, SC 29622-0357 |
Second Address | Anderson, SC 29621-5700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 16/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
366062 | (05) | SC |