Provider Demographics
NPI:1386739217
Name:MERCHANT, CHRISTOPHER C (MD ABFP PC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:C
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:MD ABFP PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9201 MONTGOMERY BLVD NE STE 301
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2467
Mailing Address - Country:US
Mailing Address - Phone:505-821-4444
Mailing Address - Fax:505-821-4395
Practice Address - Street 1:9201 MONTGOMERY BLVD NE STE 301
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2467
Practice Address - Country:US
Practice Address - Phone:505-821-4444
Practice Address - Fax:505-821-4395
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM77219207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00382779OtherRRCARE
NMP00382779OtherRRCARE
E09170Medicare UPIN