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Individual

MARIO CHRISTIANTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(877) 498-4490

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2013-02334
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
25MA10196500
NJ
207RP1001X
Pulmonary Disease Physician
25MA10196500
NJ

Other

Enumeration date
05/24/2012
Last updated
02/19/2021
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