Basic Information
| Provider Information | |||||||||
| NPI: | 1598709750 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADDUCCI | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1210 | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | SD | ||||||||
| PostalCode: | 572016210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6058827000 | ||||||||
| FaxNumber: | 6058827819 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 9TH AVE NW | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | SD | ||||||||
| PostalCode: | 572011548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6058827000 | ||||||||
| FaxNumber: | 6058827819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 08/23/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 6112 | ND | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 16787 | 05 | ND | MEDICAID | 340006903 | 01 | ND | MEDICARE RAILROAD | OTHER |