Basic Information
Provider Information
NPI: 1417179136
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNZEKER
FirstName: CHRISTOPHER
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 801 YORK ST
Address2:  
City: MANITOWOC
State: WI
PostalCode: 542204630
CountryCode: US
TelephoneNumber: 9206639016
FaxNumber: 9206841439
Practice Location
Address1: 419 W PITTSBURGH ST
Address2:  
City: GREENSBURG
State: PA
PostalCode: 156012211
CountryCode: US
TelephoneNumber: 7248375810
FaxNumber: 7248378938
Other Information
ProviderEnumerationDate: 05/03/2007
LastUpdateDate: 01/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X244002NYN Allopathic & Osteopathic PhysiciansDermatology 
207ND0101XMD435866PAN Allopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
207N00000XMD435866PAY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


Home