Basic Information
Provider Information
NPI: 1851504336
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOKES
FirstName: JAYME
MiddleName: BRUCE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 79777
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212790777
CountryCode: US
TelephoneNumber: 4346547794
FaxNumber: 4346545261
Practice Location
Address1: 1202 MEDICAL CENTER DR
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284017307
CountryCode: US
TelephoneNumber: 9103413300
FaxNumber: 9102512067
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 09/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
204F00000X6796NEN Allopathic & Osteopathic PhysiciansTransplant Surgery 
208600000X0101242359VAN Allopathic & Osteopathic PhysiciansSurgery 
208600000X2019-01249NCY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home