Provider Demographics
NPI:1861150526
Name:MUHAMMAD, JAMES LAWRENCE
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LAWRENCE
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAE
Other - Middle Name:
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 46523
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27620-6523
Mailing Address - Country:US
Mailing Address - Phone:919-332-9650
Mailing Address - Fax:
Practice Address - Street 1:6300 CREEDMOOR RD STE 170-187
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6730
Practice Address - Country:US
Practice Address - Phone:919-332-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23785411343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)