Individual
DR. JAMES LEROY DETERDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 CENTRAL DR, SANFORD, NC 27330-4159
(919) 718-9512
(919) 718-9516
Mailing address
5221 PARAMOUNT PKWY STE 220, MORRISVILLE, NC 27560-5490
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
26650
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2491
PARTNERS PROV. #
NC
01
—
28365
BCBS PROVIDER #
NC
01
—
3100127
UHC PROVIDER #
NC
01
—
390004557
RRM PROVIDER #
NC
01
—
56-1274347
TAX ID # CAROLINA KIDNEY
NC
05
—
8928365
—
NC
Enumeration date
06/08/2006
Last updated
03/05/2024
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