Provider Demographics
NPI:1346636800
Name:STARK, CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:STARK
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:STARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:AMERICA BUILDING, 4TH FLOOR
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0004
Mailing Address - Country:US
Mailing Address - Phone:301-319-5437
Mailing Address - Fax:301-319-8413
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:AMERICA BUILDING, 4TH FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0004
Practice Address - Country:US
Practice Address - Phone:301-319-5437
Practice Address - Fax:301-319-8413
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3315208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics