Basic Information
Provider Information
NPI: 1780021881
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILBUR
FirstName: CHRISTOPHER
MiddleName: JON
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 3026514200
FaxNumber:  
Practice Location
Address1: ABINGTON MEMORIAL HOSPITAL
Address2: 1200 OLD YORK ROAD
City: ABINGTON
State: PA
PostalCode: 190013720
CountryCode: US
TelephoneNumber: 2155762000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/29/2013
LastUpdateDate: 07/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMT204526PAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0208XMT204526PAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
208000000XMD457611PAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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