Provider Demographics
NPI:1740278464
Name:MAXWELL, CHRISTOPHER D (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:MAXWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2820 E ROCK HAVEN RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-4411
Mailing Address - Country:US
Mailing Address - Phone:816-380-3582
Mailing Address - Fax:816-380-6964
Practice Address - Street 1:305 E PACIFIC ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64061-2512
Practice Address - Country:US
Practice Address - Phone:816-597-3500
Practice Address - Fax:816-597-3555
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-05-15
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Provider Licenses
StateLicense IDTaxonomies
MO2002014283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1740278464Medicaid
MO1740278464Medicaid
H42273Medicare UPIN
MOK440000Medicare PIN