Provider Demographics
NPI:1568783595
Name:STAPLES, CHRISTOPHER GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GRANT
Last Name:STAPLES
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 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:
Practice Address - Street 1:255 S ROUTT ST STE 350
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2355
Practice Address - Country:US
Practice Address - Phone:303-761-7797
Practice Address - Fax:303-789-2995
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037112207R00000X
TXP9970207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine