Provider Demographics
NPI:1144336462
Name:CHRISTOPHER, NICHOLAS L
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:L
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:#232
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-966-3376
Mailing Address - Fax:202-966-5375
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:#232
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-966-3376
Practice Address - Fax:202-966-5375
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD25483207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
027672C70Medicare PIN
C61552Medicare UPIN