Provider Demographics
NPI:1265591622
Name:CHRISTLIEB, DEE EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DEE
Middle Name:EDWARD
Last Name:CHRISTLIEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 SISKIYOU BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2143
Mailing Address - Country:US
Mailing Address - Phone:541-482-2716
Mailing Address - Fax:541-488-5461
Practice Address - Street 1:935 SISKIYOU BLVD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2143
Practice Address - Country:US
Practice Address - Phone:541-482-2716
Practice Address - Fax:541-488-5461
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD12941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR023457000OtherBCBS
OR279927Medicaid
OR080003019OtherRAILROAD MEDICARE
OR023457000OtherBCBS
ORC92396Medicare UPIN