Provider Demographics
NPI:1821098302
Name:SCHUNN, CHRISTIAN D (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:D
Last Name:SCHUNN
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 1:810 E SUNFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2800
Mailing Address - Country:US
Mailing Address - Phone:662-579-3484
Mailing Address - Fax:662-579-3485
Practice Address - Street 1:810 E SUNFLOWER RD STE 100B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2828
Practice Address - Country:US
Practice Address - Phone:662-579-3484
Practice Address - Fax:662-579-3485
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010123820208600000X
WV19959208600000X, 2086S0129X
VA0101-2382002086S0129X
GA777882086S0129X
VA01012382002086S0129X
MS296842086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010187346Medicaid
VA00841355Medicare ID - Type Unspecified
VA010187346Medicaid