Provider Demographics
NPI:1912959008
Name:OBAH, CHRISTIAN C (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:C
Last Name:OBAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W 200 N STE 7
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-1873
Mailing Address - Country:US
Mailing Address - Phone:801-546-1300
Mailing Address - Fax:801-546-1301
Practice Address - Street 1:275 W 200 N STE 7
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1873
Practice Address - Country:US
Practice Address - Phone:801-546-1300
Practice Address - Fax:801-546-1301
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5867369-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology