Provider Demographics
NPI:1609076140
Name:KORNEGAY, CHRISTOPHER CHAD (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHAD
Last Name:KORNEGAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:521B MOYE BLVD. 2ND FLOOR
Mailing Address - Street 2:ECU PHYSICIANS MOYE MEDICAL CENTER
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-744-3229
Mailing Address - Fax:252-744-3924
Practice Address - Street 1:521B MOYE BLVD. 2ND FLOOR
Practice Address - Street 2:ECU PHYSICIANS MOYE MEDICAL CENTER
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-744-3229
Practice Address - Fax:252-744-3924
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2008-00655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911629Medicaid
NCP00748878OtherMEDICARE RAILROAD
NC1526VOtherBCBS NC
NC5911629Medicaid