Provider Demographics
NPI:1841617974
Name:CHRISTOPHER RUSHMEYER
Entity Type:Organization
Organization Name:CHRISTOPHER RUSHMEYER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-497-3969
Mailing Address - Street 1:PO BOX 621411
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-0123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 HARRIS HOUSTON RD
Practice Address - Street 2:UNIT 621411
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-9253
Practice Address - Country:US
Practice Address - Phone:310-497-3969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility