Provider Demographics
NPI:1518964865
Name:LADD, CHRISTOPHER DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DEAN
Last Name:LADD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 QUAIL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8516
Mailing Address - Country:US
Mailing Address - Phone:717-566-9491
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-4935
Practice Address - Fax:717-531-0336
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047428L2085R0202X
KY523762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001586473Medicaid
PAP00336646OtherMEDICARE RR IND. PI
PAP00336646OtherMEDICARE RR IND. PI
PAG27314Medicare UPIN
PA868040VPWMedicare PIN