Provider Demographics
NPI:1598753501
Name:VALENTINE, CHRISTOPHER B (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8706 S 700 E
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-1807
Mailing Address - Country:US
Mailing Address - Phone:801-508-3160
Mailing Address - Fax:801-508-3165
Practice Address - Street 1:8706 S 700 E
Practice Address - Street 2:SUITE 105
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-1807
Practice Address - Country:US
Practice Address - Phone:801-508-3160
Practice Address - Fax:801-508-3165
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT54306271205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
005754501Medicare ID - Type Unspecified
UTH67631Medicare UPIN