Provider Demographics
NPI:1659305910
Name:MCILTROT, CHRISTOPHER EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EUGENE
Last Name:MCILTROT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2148
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28145-2148
Mailing Address - Country:US
Mailing Address - Phone:704-638-5436
Mailing Address - Fax:704-638-5438
Practice Address - Street 1:103 DORSETT DR
Practice Address - Street 2:SUITE A
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2278
Practice Address - Country:US
Practice Address - Phone:704-638-5436
Practice Address - Fax:704-638-5438
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99009372086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC31517OtherPARTNERS MEDICARE
NC375758OtherALLIANCE PPO
NCC8217OtherMEDCOST
NC1223NOtherNORTH CAROLINA BC BS
NC891223NMedicaid
NCP00277626OtherRAILROAD MEDICARE
NC375758OtherALLIANCE PPO
NC31517OtherPARTNERS MEDICARE
NCG95107Medicare UPIN