Provider Demographics
NPI:1336156660
Name:VALENTINE, CHRISTOPHER W (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:W
Last Name:VALENTINE
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 1:929 JASONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2464
Mailing Address - Country:US
Mailing Address - Phone:614-538-2250
Mailing Address - Fax:614-538-2256
Practice Address - Street 1:929 JASONWAY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2464
Practice Address - Country:US
Practice Address - Phone:614-538-2250
Practice Address - Fax:614-538-2256
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080086207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2380838Medicaid
OHVA4089273Medicare PIN
OH2380838Medicaid