Healthcare Provider Details

I. General information

NPI: 1124552898
Provider Name (Legal Business Name): CHRISTOPHER GERALD CANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 COTTMAN AVE
PHILADELPHIA PA
19111-2497
US

IV. Provider business mailing address

3500 N BROAD ST
PHILADELPHIA PA
19140-4106
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-2570
  • Fax:
Mailing address:
  • Phone: 215-728-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD481183
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: