Provider Demographics
NPI:1841262714
Name:CHRISTMAN, CHAD STEVEN (DO)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:STEVEN
Last Name:CHRISTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8857
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46898-8857
Mailing Address - Country:US
Mailing Address - Phone:260-969-6200
Mailing Address - Fax:260-969-6201
Practice Address - Street 1:6819 LIMA RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46818-1145
Practice Address - Country:US
Practice Address - Phone:260-407-6207
Practice Address - Fax:260-969-6201
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2915207Q00000X
ARE-11967207Q00000X
OH34.013713207Q00000X
GA82824207Q00000X
CA17462207Q00000X
IN02002518A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200428590Medicaid
IN3519723844004OtherTRICARE
IN3937240019OtherMEDICARE DMEPOS
IN7460685OtherAETNA
IN21414OtherPHP
IN000000570560OtherANTHEM
IN3937240025OtherMEDICARE DMEPOS
IN000000513058OtherANTHEM
INP00465452OtherRAILROAD MEDICARE
IN070860BBBMedicare PIN
INP00465452OtherRAILROAD MEDICARE
IN200428590Medicaid
IN069860BBBMedicare PIN
IN7460685OtherAETNA