Provider Demographics
NPI:1578530945
Name:NORMILE, CHRISTOPHER B (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:NORMILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 1ST CAPITOL DR
Mailing Address - Street 2:STE 405
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2880
Mailing Address - Country:US
Mailing Address - Phone:636-947-2334
Mailing Address - Fax:636-940-5739
Practice Address - Street 1:400 1ST CAPITOL DR
Practice Address - Street 2:STE 405
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2880
Practice Address - Country:US
Practice Address - Phone:636-947-2334
Practice Address - Fax:636-940-5739
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO101822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203472907Medicaid
MO220317OtherBLUE CROSS BLUE SHIELD
4664266OtherAETNA
324300OtherGROUP HEALTH PLAN
P00141251OtherMEDICARE RAILROAD
992574OtherUNITED HEALTH CARE
MO175369OtherHEALTHLINK
S92007OtherEXCLUSIVE CHOICE
P00141251OtherMEDICARE RAILROAD
324300OtherGROUP HEALTH PLAN