Provider Demographics
NPI:1457361560
Name:STURBAUM, CHRISTOPHER W (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:STURBAUM
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 1:16010 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1813
Mailing Address - Country:US
Mailing Address - Phone:509-928-8040
Mailing Address - Fax:509-928-0784
Practice Address - Street 1:16010 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1813
Practice Address - Country:US
Practice Address - Phone:509-928-8040
Practice Address - Fax:509-928-0784
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025209207W00000X
WAMD00034861207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806563800Medicaid
WA0140032OtherL&I
WA180042177OtherRAILROAD MEDICARE
WA8208076Medicaid