Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0101248442 | VA |
NPI | 1336315167 |
---|---|
Provider Name | Miss Shelly-Ann James |
First Address | Selden, NY 11784-2800 |
Second Address | Fairfax, VA 22033-3952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 29/06/2021 |