Provider Demographics
NPI:1578895637
Name:FALYAR, CHRISTIAN R
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:R
Last Name:FALYAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-5120
Mailing Address - Country:US
Mailing Address - Phone:319-209-2339
Mailing Address - Fax:319-209-2339
Practice Address - Street 1:1221 S GEAR AVE
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1679
Practice Address - Country:US
Practice Address - Phone:319-768-3254
Practice Address - Fax:319-768-3266
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD139808367500000X
IA139808163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
022863C88Medicare PIN