Provider Demographics
NPI:1689633018
Name:KRUPP, CHRISTOPHER G (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:G
Last Name:KRUPP
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 1:172 KINSLEY ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3648
Mailing Address - Country:US
Mailing Address - Phone:603-595-3061
Mailing Address - Fax:603-889-3774
Practice Address - Street 1:172 KINSLEY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3648
Practice Address - Country:US
Practice Address - Phone:603-595-3061
Practice Address - Fax:603-889-3774
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8394207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH930070460OtherRAILROAD MEDICARE
NH0108705Y0NH02OtherANTHEM
MA3136426Medicaid
NH40005219Medicaid
MA3136426Medicaid
E68378Medicare UPIN