Healthcare Provider Details

I. General information

NPI: 1508865247
Provider Name (Legal Business Name): CHRISTOPHER SCOTT BRUMFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 10/25/2020
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 BROAD ST STE B SUITE B
KERNERSVILLE NC
27284-2948
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 336-992-2672
  • Fax: 336-992-2674
Mailing address:
  • Phone: 336-992-2672
  • Fax: 336-992-2674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number200000734
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: