Provider Demographics
NPI:1083648133
Name:TRETTER, CHRISTOPHER G (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:G
Last Name:TRETTER
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:MAINEHEALTH CANCER CARE
Mailing Address - Street 2:265 WESTERN AVE SUITE 2
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-661-0200
Mailing Address - Fax:
Practice Address - Street 1:MAINEHEALTH CANCER CARE
Practice Address - Street 2:265 WESTERN AVE SUITE 2
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106
Practice Address - Country:US
Practice Address - Phone:207-661-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234273207RH0003X
ME27471207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200880Medicaid
MA110077681AMedicaid
NHH18732Medicare UPIN
NH30200880Medicaid