Provider Demographics
NPI:1285655308
Name:CHRISTOFER CATTERSON MD PA
Entity Type:Organization
Organization Name:CHRISTOFER CATTERSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-454-4001
Mailing Address - Street 1:600 HOSPITAL DR
Mailing Address - Street 2:SUITE #3
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8024
Mailing Address - Country:US
Mailing Address - Phone:828-452-4001
Mailing Address - Fax:828-452-4095
Practice Address - Street 1:600 HOSPITAL DR
Practice Address - Street 2:SUITE #3
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8024
Practice Address - Country:US
Practice Address - Phone:828-452-4001
Practice Address - Fax:828-452-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900995Medicaid
NCI14443Medicare UPIN
NC2347143Medicare ID - Type Unspecified