Provider Demographics
NPI:1053332601
Name:PARONISH, CHRISTOPHER B (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:PARONISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:142 EAST CARROLL STREET
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0597
Mailing Address - Country:US
Mailing Address - Phone:814-344-9234
Mailing Address - Fax:814-344-8760
Practice Address - Street 1:142 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722
Practice Address - Country:US
Practice Address - Phone:814-344-9234
Practice Address - Fax:814-344-8760
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056268L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015574260005Medicaid
PA015574260005Medicaid
616584Medicare ID - Type Unspecified