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NPI Code Detail

MEDICARE: CHRISTOPHER MICHAEL CERALDI MD

MEDICARE: CHRISTOPHER MICHAEL CERALDI 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
12086S0129XVascular Surgery Physician24871SC
2208600000XSurgery Physician24871SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770661555
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER MICHAEL CERALDI MD
Provider Business Mailing Address
First Line : 901 W GREENWOOD ST STE 1
Second Line :
City : ABBEVILLE
State : SC
Zip : 29620-5727
Country : US
Telephone Number : 864-366-9681
Fax Number : 864-366-5600
Provider Business Practice Location Address
First Line : 901 W GREENWOOD ST STE 1
Second Line :
City : ABBEVILLE
State : SC
Zip : 29620-5727
Country : US
Telephone Number : 864-366-9681
Fax Number : 864-366-5600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/17/2020

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Directions to “ CHRISTOPHER MICHAEL CERALDI MD” Practice Location

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