Individual
ALEXEI RADIONTCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
291 BROAD ST, KERNERSVILLE, NC 27284-2932
(336) 993-8181
(336) 996-9539
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 993-8181
(336) 996-9539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9801455
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1189C
BCBS - CATAWBA
NC
05
—
891189C
—
NC
01
—
G91367
UPIN
NC
Enumeration date
07/13/2006
Last updated
03/07/2023
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