Provider Demographics
NPI:1679665608
Name:PO, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:PO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-756-7885
Mailing Address - Fax:843-756-7855
Practice Address - Street 1:3617 CASEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-2981
Practice Address - Country:US
Practice Address - Phone:843-716-7163
Practice Address - Fax:843-716-7918
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2021-02-15
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Provider Licenses
StateLicense IDTaxonomies
SC18741207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0042Medicaid
SCGP0042Medicaid