Individual
MR. CHAD ELVIS BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Mailing address
1333 SOUTHVIEW DR, BLUEFIELD, WV 24701-4317
(304) 325-4673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02659
NC
363A00000X
Physician Assistant
Primary
1872
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101671
—
NC
05
—
8101671
—
WV
Enumeration date
02/22/2011
Last updated
11/27/2023
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