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General NPI Number Information
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NPI Number | 1780724690
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Entity Type | Organization
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Legal Business Name | NORTH CAROLINA RADIATION ONCOLOGY AFFILIATES PA
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 1236 HUFFMAN MILL RD SUITE 120
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City | BURLINGTON
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State | NC
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Zip | 27215-8700
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Country | US
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Telephone | 336-538-7725
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Fax | 336-538-7785
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Provider Business Mailing Address
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Address Line | PO BOX 65595
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City | CHARLOTTE
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State | NC
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Zip | 28265-0595
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Country | US
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Telephone | 336-538-7725
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Fax | 336-538-7785
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Authorized Official
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Title or Position | PHYSICIAN
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Name | GLENN S CHRYSTAL
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Credential | MD
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Telephone | 336-538-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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