Healthcare Provider Details

I. General information

NPI: 1922810365
Provider Name (Legal Business Name): CHRISTOPHER CABAJ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 VALLEYGATE DR
FAYETTEVILLE NC
28304-3745
US

IV. Provider business mailing address

7908 LESTER DR
FAYETTEVILLE NC
28311-7420
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-5203
  • Fax:
Mailing address:
  • Phone: 910-978-9604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: