Provider Demographics
NPI:1306843123
Name:GRONER, CHRISTOPHER W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:GRONER
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 1:112 N SWAIM ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28642-2135
Mailing Address - Country:US
Mailing Address - Phone:336-526-7282
Mailing Address - Fax:336-526-7283
Practice Address - Street 1:112 N SWAIM ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28642-2135
Practice Address - Country:US
Practice Address - Phone:336-526-7282
Practice Address - Fax:336-526-7283
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937718Medicaid
NC206844GMedicare ID - Type Unspecified
NC8937718Medicaid