1104972934 NPI number — DR. CHRISTOPHER MICHAEL HOSKINS D.M.D

Table of content: DR. CHRISTOPHER MICHAEL HOSKINS D.M.D (NPI 1104972934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104972934 NPI number — DR. CHRISTOPHER MICHAEL HOSKINS D.M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSKINS
Provider First Name:
CHRISTOPHER
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104972934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
107 W FIELDSPARROW CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-5630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-676-1670
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
429 ROPER MOUNTAIN RD
Provider Second Line Business Practice Location Address:
BUILDING 300
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-458-3005
Provider Business Practice Location Address Fax Number:
864-458-7007
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  3880 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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