Individual
DR. CHRISTOPHER MARCUS LACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. PH.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3465
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2009-01865
NC
Other
Enumeration date
04/22/2008
Last updated
11/04/2009
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