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Individual
CHRISTOPHER LAKE
Active
Individual
CHRISTOPHER LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9702
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103651YPNH01
ANTHEM BC/BS
NH
01
—
080183074
RAILROAD MEDICARE
—
05
—
30009864
—
NH
01
—
5830418
AETNA GROUP
—
01
—
6861833
CIGNA HEALTHCARE
NH
01
—
9702
STATE LICENSE #
NH
Enumeration date
08/11/2005
Last updated
03/07/2023
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