Provider Demographics
NPI:1952389082
Name:COPPOLA, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:COPPOLA
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:GEISINGER MEDICAL CTR
Mailing Address - Street 2:100 N. ACADEMY AV. MC 21-70
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-2170
Mailing Address - Country:US
Mailing Address - Phone:570-271-6361
Mailing Address - Fax:570-271-5785
Practice Address - Street 1:1210 S CEDAR CREST BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6241
Practice Address - Country:US
Practice Address - Phone:610-402-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10691900208600000X, 2086S0120X
NH199502086S0120X
PAMD4357392086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery