Provider Demographics
NPI:1538280359
Name:BACHMAN, CHRISTIAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:G
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:CENTURY
Mailing Address - State:FL
Mailing Address - Zip Code:32535-0266
Mailing Address - Country:US
Mailing Address - Phone:850-256-9100
Mailing Address - Fax:850-256-9006
Practice Address - Street 1:7600 MAYO ST
Practice Address - Street 2:
Practice Address - City:CENTURY
Practice Address - State:FL
Practice Address - Zip Code:32535-2905
Practice Address - Country:US
Practice Address - Phone:850-256-9100
Practice Address - Fax:850-256-9006
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379475000Medicaid
FL379475000Medicaid
FLG38391Medicare UPIN