Provider Demographics
NPI:1497720445
Name:YOUNG, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 632832
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2832
Mailing Address - Country:US
Mailing Address - Phone:513-585-2410
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:STE 6162
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-2410
Practice Address - Fax:513-585-1057
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-083545207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64091291Medicaid
IN200496120Medicaid
OH2510705Medicaid
OHP00141469OtherRR MEDICARE
IN200496120Medicaid
OHI13134Medicare UPIN