Provider Demographics
NPI:1881643203
Name:DANIELSON, CHRISTOPHER S (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:DANIELSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SWIFTWATER RD
Mailing Address - Street 2:
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785
Mailing Address - Country:US
Mailing Address - Phone:603-747-9000
Mailing Address - Fax:
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785
Practice Address - Country:US
Practice Address - Phone:603-747-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0320000456208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1574Medicaid
NH3080080Medicaid
NH3080080Medicaid
VT0VN1574Medicaid
VTVN1574Medicare PIN
VTVN157402Medicare PIN