Provider Demographics
NPI:1740282078
Name:OLDRICH, CHRISTOPHER RICHARD (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:OLDRICH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 53RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4249
Mailing Address - Country:US
Mailing Address - Phone:941-357-7950
Mailing Address - Fax:941-840-1003
Practice Address - Street 1:1505 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4249
Practice Address - Country:US
Practice Address - Phone:941-357-7950
Practice Address - Fax:941-840-1003
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-2584213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2830Medicare PIN