Provider Demographics
NPI:1417956087
Name:BASHORE, CHRISTOPHER J (MD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:BASHORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-992-2672
Mailing Address - Fax:336-992-2674
Practice Address - Street 1:280 BROAD STREET
Practice Address - Street 2:SUITE B
Practice Address - City:KERNERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28284-2948
Practice Address - Country:US
Practice Address - Phone:336-992-2672
Practice Address - Fax:336-992-2674
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9300650207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129H7Medicaid
NCP00325634OtherRAILROAD MEDICARE
NC89129H7Medicaid
NCP00325634OtherRAILROAD MEDICARE
NC2293024AMedicare PIN