Provider Demographics
NPI:1871121384
Name:HAGUE, CHRISTIAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:HAGUE
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 1:2124 COLONEL WAY
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1092
Mailing Address - Country:US
Mailing Address - Phone:570-506-7795
Mailing Address - Fax:
Practice Address - Street 1:600 RIDGELY AVE STE 130
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1045
Practice Address - Country:US
Practice Address - Phone:570-506-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0102817208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology