Basic Information
Provider Information
NPI: 1639437452
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REDMOND
FirstName: CINTASHA
MiddleName: T'RENA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 751803
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282751803
CountryCode: US
TelephoneNumber: 3367184820
FaxNumber: 7043847830
Practice Location
Address1: 3333 SILAS CREEK PKWY
Address2:  
City: WINSTON SALEM
State: NC
PostalCode: 271033013
CountryCode: US
TelephoneNumber: 3362772200
FaxNumber: 3362772210
Other Information
ProviderEnumerationDate: 04/30/2012
LastUpdateDate: 04/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X2016-01500NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


Home