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NPI Code Detail

MEDICARE: CHRISTOPHER BULLOCK, MD

MEDICARE: CHRISTOPHER BULLOCK, MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMI

General Provider Information

NPI Number : 1134116940
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHRISTOPHER BULLOCK, MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 1501 W CHISHOLM ST
Second Line :
City : ALPENA
State : MI
Zip : 49707-1401
Country : US
Telephone Number : 989-356-7390
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CHRISTOPHER BULLOCK
Credential : MD
Telephone Number : 989-356-7390
Provider Enumeration Date : 10/06/2005
Last Update Date : 07/21/2022

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Directions to “CHRISTOPHER BULLOCK, MD ” Practice Location

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