Healthcare Provider Details

I. General information

NPI: 1699380873
Provider Name (Legal Business Name): CRISTINA FERNANDA OLIVO FREITES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BETHESDA CT STE 300
WINSTON SALEM NC
27103-3019
US

IV. Provider business mailing address

PO BOX 935983
ATLANTA GA
31193-5983
US

V. Phone/Fax

Practice location:
  • Phone: 336-660-5540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2026-03914
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2026-03914
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: