Provider Demographics
NPI:1134173032
Name:AMLING, CHRISTOPHER LEE (MD, FACS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:AMLING
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3303 SW BOND AVE, MAIL CODE CH10U
Mailing Address - Street 2:OHSU, UROLOGY
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-418-9132
Mailing Address - Fax:503-346-1501
Practice Address - Street 1:3303 SW BOND AVE, MAIL CODE CH10U
Practice Address - Street 2:OHSU, UROLOGY
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-418-9132
Practice Address - Fax:503-346-1501
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL26881208800000X
ORMD29001208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009934508Medicaid
AL051530720OtherBLUE CROSS
MS08335584OtherMISSISSIPPI MEDICAID
ALP00253526OtherRAILROAD MEDICARE
ALD73083OtherVIVA
AL009933011Medicaid
AL009934507Medicaid
AL051530722OtherBLUE CROSS
MS07026095OtherMISSISSIPPI MEDICAID
AL051530721OtherBLUE CROSS
AL009933011Medicaid