Provider Demographics
NPI:1679550180
Name:STIFF, CHRISTOPHER ALLYN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLYN
Last Name:STIFF
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 1:885 S SAWBURG AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-5926
Mailing Address - Country:US
Mailing Address - Phone:330-823-1112
Mailing Address - Fax:
Practice Address - Street 1:269 GILLMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7923
Practice Address - Country:US
Practice Address - Phone:704-660-3322
Practice Address - Fax:704-660-3330
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00465208800000X
OH71878208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH340014975OtherRAIROAD MEDICARE
OH2047216Medicaid
OH340014975OtherRAIROAD MEDICARE
OH4238110001Medicare NSC
ST0827002Medicare ID - Type Unspecified
OH2047216Medicaid