Provider Demographics
NPI:1205266202
Name:HERBERGHS, CHRISTOPHER
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HERBERGHS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 N WOOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-9461
Mailing Address - Country:US
Mailing Address - Phone:330-364-6637
Mailing Address - Fax:
Practice Address - Street 1:4337 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2643
Practice Address - Country:US
Practice Address - Phone:330-244-9881
Practice Address - Fax:330-244-9885
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2589237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH197523OtherUNITED HEALTH CARE COMMUNITY PLAN
OH002OtherMEDICAL MUTUAL
OH0330917Medicaid
OH155467OtherBLUE CROSS BLUE SHIELD
OH735195OtherBUCKEYE COMMUNITY HEALTH PLAN
OH026OtherCARESOURCE
OH0448797Medicaid