Provider Demographics
NPI:1639144769
Name:GATES, CHRISTOPHER E (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:E
Last Name:GATES
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 J DEWEY GRAY CIR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6584
Mailing Address - Country:US
Mailing Address - Phone:706-855-9565
Mailing Address - Fax:706-855-9970
Practice Address - Street 1:3624 J DEWEY GRAY CIR
Practice Address - Street 2:SUITE 250
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6584
Practice Address - Country:US
Practice Address - Phone:706-855-9565
Practice Address - Fax:706-855-9970
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA42250174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC154674Medicaid
NC7610206Medicaid
NC7610206Medicaid
GA02BDJDFMedicare ID - Type Unspecified