Provider Demographics
NPI:1437117918
Name:OLD, CHRISTOPHER W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:OLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:817 PRINCETON AVE SW
Mailing Address - Street 2:STE 106
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1333
Mailing Address - Country:US
Mailing Address - Phone:205-783-7666
Mailing Address - Fax:205-783-7399
Practice Address - Street 1:817 PRINCETON AVE SW
Practice Address - Street 2:STE 106
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1333
Practice Address - Country:US
Practice Address - Phone:205-783-7666
Practice Address - Fax:205-783-7399
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-01-31
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Provider Licenses
StateLicense IDTaxonomies
AL9698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1437117918Medicaid
AL000009601Medicaid
AL000009601Medicaid
AL102I393786Medicare UPIN
AL1437117918Medicaid
AL102I393785Medicare PIN