Provider Demographics
NPI:1740272145
Name:MANN, CHRISTOPHER R (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2005 FAIRVIEW AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3915
Mailing Address - Country:US
Mailing Address - Phone:610-258-3615
Mailing Address - Fax:610-253-4496
Practice Address - Street 1:2005 FAIRVIEW AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3915
Practice Address - Country:US
Practice Address - Phone:610-258-3615
Practice Address - Fax:610-253-4496
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD061849L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017456220007Medicaid
PA278066OtherHIGHMARK PIN
PA278066OtherHIGHMARK PIN
F88885Medicare UPIN
PA0017456220007Medicaid