Individual
CHRISTOPHER S VANDIVORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1777 CLEMENT AVE APT 449, ALAMEDA, CA 94501-8082
(203) 273-2412
Mailing address
1777 CLEMENT AVE APT 449, ALAMEDA, CA 94501-8082
(203) 273-2412
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
68711
WI
Other
Enumeration date
04/05/2016
Last updated
01/03/2025
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