Organization
NORTH CAROLINA RADIATION ONCOLOGY AFFILIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN S CHRYSTAL MD (PHYSICIAN)
(336) 538-7725
Entity
Organization
Contact information
Practice address
1236 HUFFMAN MILL RD, SUITE 120, BURLINGTON, NC 27215-8700
(336) 538-7725
(336) 538-7785
Mailing address
PO BOX 65595, CHARLOTTE, NC 28265-0595
(336) 538-7725
(336) 538-7785
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7922488
—
NC
05
—
890123M
—
NC
Enumeration date
02/08/2007
Last updated
09/26/2008
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