Provider Demographics
NPI:1770756819
Name:ELCO, CHRISTOPHER POPE (MD PHD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:POPE
Last Name:ELCO
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY STREET
Mailing Address - Street 2:APC 12
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-444-5057
Mailing Address - Fax:401-444-8514
Practice Address - Street 1:593 EDDY STREET
Practice Address - Street 2:APC 12
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-5057
Practice Address - Fax:401-444-8514
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD15191207ZP0101X
MA262572207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology