Healthcare Provider Details

I. General information

NPI: 1871517748
Provider Name (Legal Business Name): CHRISTI RAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 US HIGHWAY 117 S SUITE 120
ROCKY POINT NC
28457-9431
US

IV. Provider business mailing address

PO BOX 602484
CHARLOTTE NC
28260-2484
US

V. Phone/Fax

Practice location:
  • Phone: 910-259-0400
  • Fax: 910-675-3030
Mailing address:
  • Phone: 910-259-0400
  • Fax: 910-675-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number237785
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010-02002
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: