1992781454 NPI number — DR. CHRISTOPHER WESLEY CARDWELL D.C.

Table of content: DR. CHRISTOPHER WESLEY CARDWELL D.C. (NPI 1992781454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992781454 NPI number — DR. CHRISTOPHER WESLEY CARDWELL D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARDWELL
Provider First Name:
CHRISTOPHER
Provider Middle Name:
WESLEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992781454
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
790 HIGHWAY 70 SW
Provider Second Line Business Mailing Address:
CARDWELL CHIROPRACTIC
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-323-1177
Provider Business Mailing Address Fax Number:
828-323-1178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
790 HIGHWAY 70 SOUTHWEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-323-1177
Provider Business Practice Location Address Fax Number:
828-323-1178
Provider Enumeration Date:
12/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1771 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 890828F , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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