Healthcare Provider Details

I. General information

NPI: 1093946758
Provider Name (Legal Business Name): CHRISTOPHER P. FENDER, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 N CHURCH ST SUITE 101
GREENSBORO NC
27401-1000
US

IV. Provider business mailing address

1126 N CHURCH ST SUITE 101
GREENSBORO NC
27401-1000
US

V. Phone/Fax

Practice location:
  • Phone: 336-275-0919
  • Fax: 336-275-4849
Mailing address:
  • Phone: 336-275-0919
  • Fax: 336-275-4849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER PELL FENDER
Title or Position: OWNER
Credential: MD
Phone: 336-275-0919