Healthcare Provider Details

I. General information

NPI: 1093197741
Provider Name (Legal Business Name): CHRISTIAN A POTHERING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1648 HAMILTON ST
ALLENTOWN PA
18102-5054
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-503-8281
  • Fax:
Mailing address:
  • Phone: 484-503-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD480286
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: