Provider Demographics
NPI:1407072861
Name:STOB, CHRISTIAN MARTIN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:MARTIN
Last Name:STOB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 PEARL ST
Mailing Address - Street 2:APARTMENT 16
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3853
Mailing Address - Country:US
Mailing Address - Phone:918-640-7658
Mailing Address - Fax:
Practice Address - Street 1:191 E ORCHARD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80121-8000
Practice Address - Country:US
Practice Address - Phone:303-788-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58-002193208D00000X
CO48943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COTL-2844OtherTRAINING
CO48943OtherSTATE MEDICAL LICENSE
OH58-002193OtherTRAINING LICENSE