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General NPI Number Information
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NPI Number | 1033054853
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Entity Type | Organization
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Legal Business Name | CHALLIE MINTON MD
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 113 SCENIC OUTLET LN STE 2
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City | MOUNT AIRY
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State | NC
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Zip | 27030-9978
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Country | US
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Telephone | 336-352-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 113 SCENIC OUTLET LN STE 2
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City | MOUNT AIRY
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State | NC
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Zip | 27030-9978
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Country | US
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Telephone | 336-352-4900
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | OMID NAVID EBRAHIMI-SOHI
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Credential |
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Telephone | 214-504-4126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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