Individual
TRISTRAM D BAHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4101 N ROXBORO ST, DURHAM, NC 27704-2121
(919) 684-8111
Mailing address
4101 N ROXBORO ST, DURHAM, NC 27704-2121
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9700850
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1064J
BCBS
NC
05
—
891064J
—
NC
Enumeration date
06/29/2006
Last updated
07/08/2007
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