Provider Demographics
NPI:1619080777
Name:PEERS, CHRISTOPHER J (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:PEERS
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 1:23 AVENIDA FIORI
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-2401
Mailing Address - Country:US
Mailing Address - Phone:574-536-0019
Mailing Address - Fax:
Practice Address - Street 1:23 AVENIDA FIORI
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-2401
Practice Address - Country:US
Practice Address - Phone:574-536-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035741A174400000X, 207Y00000X
KY46935207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100113410Medicaid
KYP01315179OtherRAILROAD MEDICARE
IN259370137Medicare PIN
KYK124840Medicare PIN
KYK124844Medicare PIN
KYK124842Medicare PIN
KYP01315179OtherRAILROAD MEDICARE
IN100113410Medicaid
KYK124841Medicare PIN
IN226680Medicare PIN