Individual
CHRISTOPHER JAMES VAN OOTEGHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4530 FAYETTEVILLE RD, RALEIGH, NC 27603-3614
(919) 235-1930
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
104049
NC
363AM0700X
Medical Physician Assistant
Primary
104049
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992709935
—
NC
01
—
Q36915
UPIN
NC
Enumeration date
06/08/2005
Last updated
10/01/2025
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