Provider Demographics
NPI:1902861560
Name:MERIAM, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:MERIAM
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 1:130 FISHER RD
Mailing Address - Street 2:BUILDING A, SUITE 2-2
Mailing Address - City:BERLIN
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9516
Mailing Address - Country:US
Mailing Address - Phone:802-229-2663
Mailing Address - Fax:802-229-6645
Practice Address - Street 1:130 FISHER RD
Practice Address - Street 2:BUILDING A, SUITE 2-2
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-229-2663
Practice Address - Fax:802-229-6645
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420009792207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1887Medicaid
VT200035079OtherRAIL ROAD MEDICARE
NH30207743Medicaid
NH30207743Medicaid
VTVN1887Medicare PIN
VTNX2006Medicare PIN
G24414Medicare UPIN