Healthcare Provider Details

I. General information

NPI: 1447411962
Provider Name (Legal Business Name): CHRISTOPHER PATRICK CULLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 PREMIER DRIVE SUITE 203
HIGH POINT NC
27265-8356
US

IV. Provider business mailing address

1701 WESTCHESTER DRIVE SUITE 850
HIGH POINT NC
27262-7254
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2200
  • Fax: 336-802-2201
Mailing address:
  • Phone: 336-802-2000
  • Fax: 336-802-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2011-01045
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number149458
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: