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NPI Code Detail

MEDICARE: CHRISTOPHER P DALE MD

MEDICARE: CHRISTOPHER P DALE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician48113WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22024890OTHERWIPHYSICIANS PLUS

General Provider Information

NPI Number : 1639116890
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER P DALE MD
Provider Business Mailing Address
First Line : 36500 AURORA DR
Second Line :
City : SUMMIT
State : WI
Zip : 53066-4899
Country : US
Telephone Number : 262-434-3700
Fax Number :
Provider Business Practice Location Address
First Line : 3524 E MILWAUKEE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-1626
Country : US
Telephone Number : 608-756-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/18/2023

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