Provider Demographics
NPI:1619263191
Name:HELLER, CHRISTOPHER J II (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:HELLER
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3913 DARROW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2621
Mailing Address - Country:US
Mailing Address - Phone:330-688-7900
Mailing Address - Fax:330-688-1866
Practice Address - Street 1:3913 DARROW RD STE 100
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2621
Practice Address - Country:US
Practice Address - Phone:330-688-7900
Practice Address - Fax:330-688-1866
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.010899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0091138Medicaid