Provider Demographics
NPI:1023755816
Name:CANNING, CHRISTOPHER PAUL (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:CANNING
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-294-5000
Mailing Address - Fax:207-294-5227
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9422
Practice Address - Country:US
Practice Address - Phone:207-294-5000
Practice Address - Fax:207-294-5227
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2025-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEPA2795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant