Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 121265 | OH |
N | 208800000X | Urologist | 1543 | WI |
N | 208800000X | Urologist | 49995-20 | WI |
NPI | 1043260698 |
---|---|
Provider Name | Matthew W Christian |
First Address | Chillicothe, OH 45601-9031 |
Second Address | Chillicothe, OH 45601-7502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0099882 | (05) | OH |