Provider Demographics
NPI:1275582025
Name:DUPLASS, CHRISTIAN JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:JAMES
Last Name:DUPLASS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1161 MCDERMOTT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4064
Mailing Address - Country:US
Mailing Address - Phone:610-701-7011
Mailing Address - Fax:610-429-5199
Practice Address - Street 1:1161 MCDERMOTT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4064
Practice Address - Country:US
Practice Address - Phone:610-701-7011
Practice Address - Fax:610-429-5199
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-010686-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2359401OtherMLHC TIN
H93516Medicare UPIN
PA440771OtherMLHC MEDICARE AA #
PA01956681Medicaid
PA183534HK1Medicare PIN
PA01956681Medicaid
PA391941Medicare Oscar/Certification