Basic Information
| Provider Information | |||||||||
| NPI: | 1902006646 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DILLINGHAM | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | SANGER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602658 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367162011 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1002 N CHURCH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368902210 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 200300085 | NC | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 01136B | 01 | NC | UPIN | OTHER | 146GF | 01 | BCBS | OTHER | 5907675 | 05 | NC | MEDICAID | 810642 | 01 | PARTNERS | OTHER | 9073058 | 01 | AETNA | OTHER | 3810009758 | 05 | WV | MEDICAID | Q85003 | 05 | SC | MEDICAID | 202032 | 01 | MEDCOST | OTHER |