Provider Demographics
NPI:1598892895
Name:FURMICK, CHRISTINE J (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:J
Last Name:FURMICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1515 DOCTORS CIR
Mailing Address - Street 2:HANOVER MEDICAL SPECIALISTS
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7403
Mailing Address - Country:US
Mailing Address - Phone:910-763-6332
Mailing Address - Fax:910-763-0291
Practice Address - Street 1:1515 DOCTORS CIR
Practice Address - Street 2:HANOVER MEDICAL SPECIALISTS
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7403
Practice Address - Country:US
Practice Address - Phone:910-763-6332
Practice Address - Fax:910-763-0291
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2769048Medicare PIN