Provider Demographics
NPI:1437145570
Name:GRUSSENDORF, CHRISTOPHER MARK (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARK
Last Name:GRUSSENDORF
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:RANDOLPH AFB MTF
Mailing Address - Street 2:221 THIRD STREET WEST, BLDG 1040
Mailing Address - City:JBSA, RANDOLPH
Mailing Address - State:TX
Mailing Address - Zip Code:78150
Mailing Address - Country:US
Mailing Address - Phone:210-652-8544
Mailing Address - Fax:
Practice Address - Street 1:RANDOLPH AFB MTF
Practice Address - Street 2:221 THIRD STREET WEST, BLDG 1040
Practice Address - City:JBSA, RANDOLPH
Practice Address - State:TX
Practice Address - Zip Code:78150
Practice Address - Country:US
Practice Address - Phone:210-652-8544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-06-20
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Provider Licenses
StateLicense IDTaxonomies
VA01012298702083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine