Provider Demographics
NPI:1689634792
Name:DAVANZO, CHRISTIE C (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:C
Last Name:DAVANZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:628 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7730
Mailing Address - Country:US
Mailing Address - Phone:336-478-1016
Mailing Address - Fax:336-851-1737
Practice Address - Street 1:628 GREEN VALLEY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7730
Practice Address - Country:US
Practice Address - Phone:336-478-1016
Practice Address - Fax:336-851-1737
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2011-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC99015192080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine