Provider Demographics
NPI:1750335196
Name:KOENIG, CHRISTOPHER D (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:KOENIG
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 1:4440 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3315
Mailing Address - Country:US
Mailing Address - Phone:913-439-7457
Mailing Address - Fax:
Practice Address - Street 1:12800 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2706
Practice Address - Country:US
Practice Address - Phone:913-661-9990
Practice Address - Fax:913-661-9963
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429507207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP62B703Medicare ID - Type Unspecified
KSH57496Medicare UPIN