Physician Compare National (NPI:1962490623)

HEALTHCARE PROVIDER: CHRISTOPHER BULLOCK MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1962490623
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688866650
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101008000474
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BULLOCK
	Individual professional last name
Provider First Name	CHRISTOPHER
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1501 W CHISHOLM ST
	Group Practice or individual's line 1 address
City	ALPENA
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	497071401
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9893567390
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230036
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MIDMICHIGAN MEDICAL CENTER - ALPENA
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y