Individual
JAMES DOUGLAS TEASDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3821 ED DR, RALEIGH, NC 27612-8038
(984) 262-8026
Mailing address
2732 FOREST DR, WINSTON SALEM, NC 27104-2014
(336) 413-5424
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
363A0000X
NC
Other
Enumeration date
10/18/2021
Last updated
11/15/2021
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