Healthcare Provider Details

I. General information

NPI: 1093706087
Provider Name (Legal Business Name): CHRISTOPHER S. CALHOUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 SOUTH MAST ROAD ELLIOT FAMILY MEDICINE AT GLEN LAKE
GOFFSTOWN NH
03045
US

IV. Provider business mailing address

89 SOUTH MAST ROAD ELLIOT FAMILY MEDICINE AT GLEN LAKE
GOFFSTOWN NH
03045
US

V. Phone/Fax

Practice location:
  • Phone: 603-497-5661
  • Fax: 603-497-5740
Mailing address:
  • Phone: 603-497-5661
  • Fax: 603-497-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11266
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: