Provider Demographics
NPI:1699729913
Name:CHRISTOPHER, MARK G (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:G
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-441-1934
Mailing Address - Fax:740-446-5486
Practice Address - Street 1:500 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9360
Practice Address - Country:US
Practice Address - Phone:855-446-5387
Practice Address - Fax:740-446-5573
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-9998207RG0100X
WV15248207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1699729913OtherNPI
001714038OtherMOUNTAIN STATE BCBS
OH0554672OtherMOLINA MEDICAID
000000007341OtherANTHEM BCBS
OH000000185259OtherUNISON MEDICAID
WV0084269000Medicaid
100004591OtherRR MEDICARE
OH310917085117OtherCARESOURCE MEDICAID
000000007341OtherANTHEM BCBS
001714038OtherMOUNTAIN STATE BCBS
WV0084269000Medicaid