Provider Demographics
NPI:1922036953
Name:DONOHUE, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:DONOHUE
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 1:1440 W GATESBURG RD
Mailing Address - Street 2:
Mailing Address - City:WARRIORS MARK
Mailing Address - State:PA
Mailing Address - Zip Code:16877-6209
Mailing Address - Country:US
Mailing Address - Phone:570-687-6785
Mailing Address - Fax:
Practice Address - Street 1:1000 DUNHAM DR
Practice Address - Street 2:EMERGENCY SERVICES
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2666
Practice Address - Country:US
Practice Address - Phone:570-346-9193
Practice Address - Fax:570-346-8009
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065566L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F67261Medicare UPIN
014204JNYMedicare ID - Type Unspecified