Provider Demographics
NPI:1841571395
Name:PETERSON, CHRISTIAN ERIK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ERIK
Last Name:PETERSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CHRISTIAN
Other - Middle Name:ERIK
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, PHARMD, RPH
Mailing Address - Street 1:151 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-2852
Mailing Address - Country:US
Mailing Address - Phone:603-635-9153
Mailing Address - Fax:603-635-8769
Practice Address - Street 1:151 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-2852
Practice Address - Country:US
Practice Address - Phone:603-635-9153
Practice Address - Fax:603-635-8769
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1862183500000X
MAPH25712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist