Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 7403 | NC |
Y | 213EG0000X | General Practice | 7403 | NC |
NPI | 1003845538 |
---|---|
Provider Name | Christopher N Ballinger |
First Address | Winston-Salem, NC 27106-5312 |
Second Address | Winston-Salem, NC 27106-5312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 13/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017U2 | BCBSNC (01) | NC |
89902H1 | (05) | NC |