Provider Demographics
NPI:1013366400
Name:ROGHAIR, CHRISTOPHER JOHN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:ROGHAIR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 W GRANT ST
Mailing Address - Street 2:APARTMENT 19G
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2309
Mailing Address - Country:US
Mailing Address - Phone:312-945-8949
Mailing Address - Fax:
Practice Address - Street 1:13900 NORTHDALE BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-9627
Practice Address - Country:US
Practice Address - Phone:763-428-3757
Practice Address - Fax:763-428-9820
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist