Individual
CHRISTOPHER JOHANNUS VANDERMEER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054
(704) 867-8021
(704) 864-4606
Mailing address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054
(704) 867-8021
(704) 864-4606
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
200101148
NC
2085R0202X
Diagnostic Radiology Physician
Primary
200101148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137Y2
BLUE CROSS BLUE SHIELD
—
01
—
3616235
AETNA HMO
—
01
—
560988142
UNITED HEALTHCARE
—
01
—
7239629
AETNA PPO
—
01
—
804854
PARTNERS
—
05
—
8913742
—
NC
01
—
D4992
MEDCOST
—
05
—
N01141
—
SC
01
—
P00192298
RAILROAD MEDICARE
—
Enumeration date
11/22/2005
Last updated
07/10/2008
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