Provider Demographics
NPI:1851341937
Name:CHRIS A. PATE MD PA
Entity Type:Organization
Organization Name:CHRIS A. PATE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:O
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-544-6318
Mailing Address - Street 1:PO BOX 2831
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-2831
Mailing Address - Country:US
Mailing Address - Phone:919-544-6318
Mailing Address - Fax:919-544-6336
Practice Address - Street 1:2280 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-9546
Practice Address - Country:US
Practice Address - Phone:919-735-1400
Practice Address - Fax:919-581-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32555261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC013YPOtherBCBS-NC GROUP
NC788533OtherMEDCOST GROUP
NC89013YPMedicaid
NC013YPOtherBCBS-NC GROUP
NC788533OtherMEDCOST GROUP
NC89013YPMedicaid