Healthcare Provider Details

I. General information

NPI: 1255410577
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL SIMPSON P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 OLEANDER DR STE 100
WILMINGTON NC
28403-6844
US

IV. Provider business mailing address

PO BOX 52411
PHOENIX AZ
85072-2411
US

V. Phone/Fax

Practice location:
  • Phone: 910-338-3494
  • Fax: 910-338-0860
Mailing address:
  • Phone: 919-785-3400
  • Fax: 919-783-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001014904
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number410
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: