Healthcare Provider Details

I. General information

NPI: 1518964865
Provider Name (Legal Business Name): CHRISTOPHER DEAN LADD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

643 HOFFMAN DR
HARRISBURG PA
17111-3837
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-4935
  • Fax: 717-531-0336
Mailing address:
  • Phone: 717-421-2924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD047428L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG148530
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier001586473
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
IdentifierP00336646
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICARE RR IND. PI
# 3
Identifier116935100
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: