Healthcare Provider Details

I. General information

NPI: 1033644729
Provider Name (Legal Business Name): CHRISTOPHER LANIER CARPENTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD STE 6E34
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD STE 6E34
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-4186
  • Fax: 302-733-6905
Mailing address:
  • Phone: 302-733-4186
  • Fax: 302-733-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberMT227744
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberC1-0027270
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101268538
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC1-0027270
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: