Provider Demographics
NPI:1225195274
Name:WAYNE A CHRISTOPHERSON & ASSOCIATES INC
Entity Type:Organization
Organization Name:WAYNE A CHRISTOPHERSON & ASSOCIATES INC
Other - Org Name:WA CHRISTOPHERSON ASSOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTOPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-621-6464
Mailing Address - Street 1:1400 LOCUST ST
Mailing Address - Street 2:SUITE 3121
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5114
Mailing Address - Country:US
Mailing Address - Phone:412-621-6464
Mailing Address - Fax:412-232-3175
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:SUITE 3121
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-621-6464
Practice Address - Fax:412-232-3175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033040E207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012533870002Medicaid
WA671127Medicare PIN
PAWA671127Medicare PIN
PA671127Medicare PIN
671127Medicare PIN