Provider Demographics
NPI:1306812797
Name:MADDEN, CHRISTOPHER RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RONALD
Last Name:MADDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30369
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27130-0369
Mailing Address - Country:US
Mailing Address - Phone:336-999-8888
Mailing Address - Fax:336-999-8889
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-5856
Practice Address - Fax:336-718-9545
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900922207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42621OtherBCBS
NC89136UJMedicaid
NC2025164BMedicare PIN
NC89136UJMedicaid
NC2025164AMedicare PIN
NCP00327981Medicare PIN