Provider Demographics
NPI:1255385019
Name:VITTONE, CHRISTIAN M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:M
Last Name:VITTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:210 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1106
Mailing Address - Country:US
Mailing Address - Phone:724-238-2121
Mailing Address - Fax:724-238-9870
Practice Address - Street 1:210 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1106
Practice Address - Country:US
Practice Address - Phone:724-238-2121
Practice Address - Fax:724-238-9870
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD063006L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG62574Medicare UPIN