Provider Demographics
NPI:1104169416
Name:KLARE, CHRISTIAN MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MATTHEW
Last Name:KLARE
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 1:17 RIVERSIDE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1383
Mailing Address - Country:US
Mailing Address - Phone:603-883-0091
Mailing Address - Fax:603-881-3739
Practice Address - Street 1:17 RIVERSIDE ST STE 101
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1383
Practice Address - Country:US
Practice Address - Phone:603-883-0091
Practice Address - Fax:603-881-3739
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-00154207X00000X
NH17877207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730004OtherNSC #
NC1104169416Medicaid
SCNC3377Medicaid
NH3118197Medicaid