Basic Information
Provider Information
NPI: 1235140328
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGGE
FirstName: CHRISTOPHER
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3691 RUTGER AVE
Address2:  
City: ST. LOUIS
State: MO
PostalCode: 631102515
CountryCode: US
TelephoneNumber: 3149776828
FaxNumber: 3149776872
Practice Location
Address1: 1465 S GRAND BLVD
Address2:  
City: ST. LOUIS
State: MO
PostalCode: 631041003
CountryCode: US
TelephoneNumber: 3142684101
FaxNumber: 3145775379
Other Information
ProviderEnumerationDate: 08/11/2006
LastUpdateDate: 07/31/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X2005002434MON Allopathic & Osteopathic PhysiciansPediatrics 
2080P0207X2005002434MOY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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