Healthcare Provider Details

I. General information

NPI: 1336110386
Provider Name (Legal Business Name): CHRISTINA COLLURA DO, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E 7TH ST UNIT A
CHARLOTTE NC
28204-4398
US

IV. Provider business mailing address

15634 KNOX HILL RD
HUNTERSVILLE NC
28078-5690
US

V. Phone/Fax

Practice location:
  • Phone: 704-372-7900
  • Fax:
Mailing address:
  • Phone: 704-775-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberDO82952
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number2009-01137
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: