Provider Demographics
NPI:1215025283
Name:TROTZ, CHRISTOPHER RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RENE
Last Name:TROTZ
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 1:1 EVES DR STE 111
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3125
Mailing Address - Country:US
Mailing Address - Phone:856-357-3247
Mailing Address - Fax:856-249-9164
Practice Address - Street 1:1 EVES DR STE 111
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3125
Practice Address - Country:US
Practice Address - Phone:856-625-2407
Practice Address - Fax:856-848-1682
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07948800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094094Medicare ID - Type Unspecified
NJP00322196Medicare PIN
I39713Medicare UPIN