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Individual

CHRISTOPHER MICHAEL JOACHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
124 BETTIS ACADEMY RD, GRANITEVILLE, SC 29829-3107
(803) 392-3724
(803) 234-5593
Mailing address
367 S GULPH RD, ATTN IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(803) 392-3724
(803) 234-5593

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116032120
VA
207Q00000X
Family Medicine Physician
Primary
83702
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
837027
SC
Enumeration date
06/28/2018
Last updated
09/16/2021
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