Individual
MR. CHRISTOPHER SHANE GEORGEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2101 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-3726
(336) 955-1379
Mailing address
2101 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-3726
(336) 955-1379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0010-07622
NC
363AM0700X
Medical Physician Assistant
Primary
0010-07622
NC
Other
Enumeration date
10/02/2017
Last updated
12/27/2017
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