Provider Demographics
NPI:1154826402
Name:ORTENGREN, CHRISTOPHER DONOVAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DONOVAN
Last Name:ORTENGREN
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 1:246 PLEASANT ST BLDG WEST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-3388
Mailing Address - Fax:603-227-7536
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 1
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-3388
Practice Address - Fax:603-227-7536
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH24187208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program