Provider Demographics
NPI:1649269150
Name:ADDIS, CHRISTOPHER T (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:T
Last Name:ADDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:LANCASTER GENERAL HOSPITAL
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-8144
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:LANCASTER GENERAL HOSPITAL
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043006L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA563521OtherAETNA HMO
PAE77514OtherHEALTH ASSURANCE
PA661702OtherHIGHMARK BLUE SHIELD
PA33804 S1QAOtherGEISINGER HEALTH PLAN
PA02015602OtherCAPITAL BLUE CROSS
PA110142857OtherRAILROAD MEDICARE
PA0012352800004Medicaid
PA1519247OtherGATEWAY HEALTH PLAN
PAP002536OtherGATEWAY HEALTH PLAN
PA5182104OtherAETNA NON-HMO
PA33804 S1QAOtherGEISINGER HEALTH PLAN
PA661702OtherHIGHMARK BLUE SHIELD