Provider Demographics
NPI:1780630749
Name:LONGO, CHRISTOPHER ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:LONGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3713 BENSON DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7372
Mailing Address - Country:US
Mailing Address - Phone:919-235-3400
Mailing Address - Fax:919-235-3401
Practice Address - Street 1:3713 BENSON DRIVE, SUITE 201
Practice Address - Street 2:CAROLINA VASCULAR SURGERY & DIAGNOSTICS, PA
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7372
Practice Address - Country:US
Practice Address - Phone:919-235-3400
Practice Address - Fax:919-235-3401
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI430618174400000X
NC200600954174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist