Provider Demographics
NPI:1174624035
Name:CHRISTOPHER, ERIC JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-5004
Mailing Address - Country:US
Mailing Address - Phone:919-606-0469
Mailing Address - Fax:
Practice Address - Street 1:201 N FRONT ST STE 508
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-5092
Practice Address - Country:US
Practice Address - Phone:910-765-1003
Practice Address - Fax:910-765-1004
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36111138207R00000X, 2084P0800X
WI48922207R00000X, 2084P0800X
NC9801208207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH15719Medicaid
NC2280672AMedicaid
NC2280672AMedicare PIN
NCH15719Medicaid