Provider Demographics
NPI:1639135965
Name:SWEENEY, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SWEENEY
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 1:10475 READING RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2563
Mailing Address - Country:US
Mailing Address - Phone:513-585-9600
Mailing Address - Fax:513-585-9668
Practice Address - Street 1:10475 READING RD
Practice Address - Street 2:SUITE 405
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2563
Practice Address - Country:US
Practice Address - Phone:513-585-9600
Practice Address - Fax:513-585-9668
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045870S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00856766OtherMEDICARE RR
OH0525828Medicaid
KY64083694Medicaid
OHP00856766OtherMEDICARE RR
OH0504866Medicare PIN