Basic Information
| Provider Information | |||||||||
| NPI: | 1679517932 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOPROWSKI | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12870 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198502870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027330374 | ||||||||
| FaxNumber: | 3027330854 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 OGLETOWN STANTON RD | ||||||||
| Address2: | STE 1109 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026234800 | ||||||||
| FaxNumber: | 3026234850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 02/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | C10006474 | DE | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | D0058737 | MD | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | MD022600E | PA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 920006915 | 01 | DE | RAILROAD MEDICARE | OTHER | P00761474 | 01 | MD | RAILROAD MEDICARE | OTHER | P01311292 | 01 | PA | RAILROAD MEDICARE | OTHER | 377430901 | 05 | MD | MEDICAID | 000892024 | 05 | PA | MEDICAID | 0001179301 | 05 | DE | MEDICAID |