Provider Demographics
NPI:1073730248
Name:PRZYBYCIN, CHRISTOPHER GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GREGORY
Last Name:PRZYBYCIN
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 1:9500 EUCLID AVE
Mailing Address - Street 2:L25
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-8421
Mailing Address - Fax:216-445-3707
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:L25
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-8421
Practice Address - Fax:216-445-3707
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43060207ZP0102X
MI4301081682207ZP0102X
MI4301081662390200000X
MDD67176207ZP0102X
OH35.098560207ZP0101X
NY252621207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018316400Medicaid