Provider Demographics
NPI:1467435149
Name:LOUIE, CHRISTOPHER Y C (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:Y C
Last Name:LOUIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1619 N GREENWOOD ST
Mailing Address - Street 2:SUIT #210
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2656
Mailing Address - Country:US
Mailing Address - Phone:719-542-5121
Mailing Address - Fax:719-584-4736
Practice Address - Street 1:1619 N GREENWOOD ST
Practice Address - Street 2:SUIT #210
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2656
Practice Address - Country:US
Practice Address - Phone:719-542-5121
Practice Address - Fax:719-584-4736
Is Sole Proprietor?:No
Enumeration Date:2005-11-27
Last Update Date:2007-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO24504208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01245042Medicaid
CO01245042Medicaid