Provider Demographics
NPI:1366856817
Name:FORT, CHRISTOFER JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOFER
Middle Name:JOHN
Last Name:FORT
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 1:130 CT RTE 37
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812
Mailing Address - Country:US
Mailing Address - Phone:203-746-6000
Mailing Address - Fax:203-739-8402
Practice Address - Street 1:7 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3433
Practice Address - Country:US
Practice Address - Phone:860-567-0130
Practice Address - Fax:860-567-0125
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56411208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist