Healthcare Provider Details

I. General information

NPI: 1700949443
Provider Name (Legal Business Name): CHRISTIAN PETER WILKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2006
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST STE 205
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST STE 205
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-0584
  • Fax: 603-227-7560
Mailing address:
  • Phone: 603-224-0584
  • Fax: 603-227-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number13386
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: