Provider Demographics
NPI:1730223694
Name:DUARTE, CHRISTOPHER A (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:DUARTE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 OSLOSKI RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-9217
Mailing Address - Country:US
Mailing Address - Phone:406-297-3145
Mailing Address - Fax:406-297-3364
Practice Address - Street 1:304 OSLOSKI RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9217
Practice Address - Country:US
Practice Address - Phone:406-297-3145
Practice Address - Fax:406-297-3364
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01139363A00000X
WAPA10005241363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant