Provider Demographics
NPI:1598738247
Name:EGGERT, CHRISTOPH H (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPH
Middle Name:H
Last Name:EGGERT
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 1:3833 CARDINAL POINT TRL
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-8141
Mailing Address - Country:US
Mailing Address - Phone:608-203-6223
Mailing Address - Fax:
Practice Address - Street 1:2840 INDEX RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53713-3117
Practice Address - Country:US
Practice Address - Phone:608-229-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43642207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN862952800Medicaid
H40982Medicare UPIN
MN390000358Medicare ID - Type Unspecified
MN110223456Medicare ID - Type UnspecifiedRAILROAD