Individual
JAMES JOSEPH PERUMPILLICHIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
200500813
NC
2085R0204X
Vascular & Interventional Radiology Physician
200500813
NC
2085U0001X
Diagnostic Ultrasound Physician
200500813
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10195501
—
VA
01
—
13917
BCBS
—
05
—
3810003146
—
WV
05
—
5901550
—
NC
01
—
7379724
AETNA
—
01
—
806762
PARTNERS
—
01
—
E3861
MEDCOST
—
01
—
P00300082
RR MEDICARE
—
05
—
Q0081N
—
SC
Enumeration date
12/02/2005
Last updated
10/08/2010
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