Provider Demographics
NPI:1700892072
Name:COMFORT, CHRISTOPHER JOHN (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:COMFORT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:293 OLD MOCKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-1930
Mailing Address - Country:US
Mailing Address - Phone:704-872-8711
Mailing Address - Fax:704-872-5866
Practice Address - Street 1:293 OLD MOCKSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1903
Practice Address - Country:US
Practice Address - Phone:704-872-8711
Practice Address - Fax:704-872-5866
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-04-04
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Provider Licenses
StateLicense IDTaxonomies
NC104151363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ36429Medicare UPIN
NCQ36429Medicare UPIN