Provider Demographics
NPI:1891785499
Name:MAFFIT, CHRISTOPHER JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:MAFFIT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 OLD BALLAS RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7026
Mailing Address - Country:US
Mailing Address - Phone:314-725-3358
Mailing Address - Fax:314-725-1733
Practice Address - Street 1:11720 OLD BALLAS RD STE 2
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7028
Practice Address - Country:US
Practice Address - Phone:314-725-3358
Practice Address - Fax:314-725-1733
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001032183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO350056210OtherRAILROAD MEDICARE PRO
MO3800A1OtherBCBS CHOICE PAR PROVIDER
MO157374OtherBCBS ALLIANCE PAR PROVIDE
MO4401309OtherUHC NON-PAR ID
MO471480OtherHEALTHLINK NON-PAR
MO4401309OtherUHC NON-PAR ID
MOU89836Medicare UPIN