Provider Demographics
NPI:1366736878
Name:HAUCK, CHRISTOPHER GALE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GALE
Last Name:HAUCK
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 1:101 MASON FARM RD STE 3100
Mailing Address - Street 2:CB# 7705
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6136
Mailing Address - Country:US
Mailing Address - Phone:919-966-1459
Mailing Address - Fax:919-843-9355
Practice Address - Street 1:101 MASON FARM RD STE 3100
Practice Address - Street 2:CB# 7705
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6136
Practice Address - Country:US
Practice Address - Phone:919-966-1459
Practice Address - Fax:919-843-9355
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172804390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program