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General NPI Number Information
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NPI Number | 1043709652
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Entity Type | Individual
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Provider Name | CHRISTOPHER CLARKE VASILEFF MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 210 BEATTY DR
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City | BELMONT
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State | NC
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Zip | 28012-2716
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Country | US
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Telephone | 704-266-3100
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Fax | 704-867-6401
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Provider Business Mailing Address
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Address Line | 2345 COURT DR
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City | GASTONIA
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State | NC
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Zip | 28054-2151
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Country | US
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Telephone | 704-865-0077
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Fax | 704-867-6401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 89615
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301114781
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License Number State | MI
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