Provider Demographics
NPI:1568489490
Name:SCHLICHT, CHRISTIAN R (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:R
Last Name:SCHLICHT
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 1:3800 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8412
Mailing Address - Country:US
Mailing Address - Phone:970-669-8881
Mailing Address - Fax:970-669-4200
Practice Address - Street 1:3800 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8412
Practice Address - Country:US
Practice Address - Phone:970-669-8881
Practice Address - Fax:970-669-4200
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39535207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMF8469Medicaid
342632502Medicare Oscar/Certification
NMF8469Medicaid