Provider Demographics
NPI:1760485486
Name:WARNIMONT, CHRISTOPHER JOHN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:WARNIMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-766-0547
Mailing Address - Fax:336-766-0549
Practice Address - Street 1:105 STADIUM OAKS DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8962
Practice Address - Country:US
Practice Address - Phone:336-766-0547
Practice Address - Fax:336-766-0549
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95-00759208000000X, 207R00000X
NC9500759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
66568863OtherCHAMPUS
NCP00457709OtherRAILROAD MEDICARE
0402116OtherUNITED HEALTHCARE
2624329OtherAETNA HMO OPOS
58459OtherMEDCOST
P00165221OtherRAILROAD MEDICARE
NC8985749Medicaid
5296039OtherAETNA PPO POS
8119782OtherMAMSI
85749OtherBCBS
10527OtherPARTNERS
85749OtherBCBS
5296039OtherAETNA PPO POS
F70373Medicare UPIN
NC2216014EMedicare PIN