Healthcare Provider Details

I. General information

NPI: 1710955638
Provider Name (Legal Business Name): CHRISTOPHER J MOTTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LYSTRA ROGERS DR
LEWISBURG PA
17837-8807
US

IV. Provider business mailing address

ONE HOSPITAL DRIVE SUITE 306
LEWISBURG PA
17837-9350
US

V. Phone/Fax

Practice location:
  • Phone: 570-523-3290
  • Fax: 570-524-5231
Mailing address:
  • Phone: 570-522-4110
  • Fax: 570-768-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberMD072095L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberMD072095L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD072095L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: