1275566937 NPI number — CHRISTOPHER R POWERS PA

Table of content: CHRISTOPHER R POWERS PA (NPI 1275566937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275566937 NPI number — CHRISTOPHER R POWERS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWERS
Provider First Name:
CHRISTOPHER
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1275566937
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4601 PARK RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28209-3239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-323-2000
Provider Business Mailing Address Fax Number:
704-945-7681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15825 JOHN J DELANEY DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28277-3146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-323-3400
Provider Business Practice Location Address Fax Number:
704-323-3403
Provider Enumeration Date:
07/08/2006

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: 363A00000X , with the licence number:  0010-04880 , 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: 0010-04880 . This is a "NC LICENSE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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