Doctor Name: | DR. CHRISTOPHER LAWRENCE PULLIAM |
NPI Number: | 1134183270 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | 0359 |
Business Practice Address: | 3001 A 6th St Naval Health Clinic Great Lakes, IL - 60088 |
Business Phone Number: | 8476883995 |
Business Fax Number: | |
Mailing Address: | 3098 Chatfield Drive, HIGHLAND PARK |
State: | IL |
Postal Code: | 60035 |
Phone Number: | 9137084802 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 11/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0000X |
License Number: | 0359 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Sports Medicine |
Taxonomy Definition: |