Provider Demographics
NPI:1518070663
Name:LAFLURE, CHRISTOPHER MICHEAL (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHEAL
Last Name:LAFLURE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 STATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:NC
Mailing Address - Zip Code:27013-9418
Mailing Address - Country:US
Mailing Address - Phone:704-278-4053
Mailing Address - Fax:704-278-2951
Practice Address - Street 1:11711 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:NC
Practice Address - Zip Code:27013-9418
Practice Address - Country:US
Practice Address - Phone:704-278-4053
Practice Address - Fax:704-278-2951
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00501363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ72100Medicare UPIN