MEDICARE: CHRISTOPHER PINN 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
1	207R00000X	Internal Medicine Physician	16449	WI

General Provider Information

NPI Number	:	1659743250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER PINN MD

Provider Business Mailing Address
First Line	:	622 BODART STREET
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 BODART ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-4923
Country	:	US
Telephone Number	:	920-437-9773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2015
Last Update Date	:	10/22/2015

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