Provider Demographics
NPI:1003138868
Name:CHAMP, COLIN E (MD)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:E
Last Name:CHAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4800 FRIENDSHIP AVE STE GR508
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-1923
Mailing Address - Fax:412-578-1936
Practice Address - Street 1:4800 FRIENDSHIP AVE STE GR508
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-1923
Practice Address - Fax:412-578-1936
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4486242085R0001X
NC2517512085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology