Provider Demographics
NPI:1932412020
Name:DESKINS, CHRISTOPHER RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RUSSELL
Last Name:DESKINS
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 1:810 CLAIRTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4567
Mailing Address - Country:US
Mailing Address - Phone:412-466-5004
Mailing Address - Fax:412-466-7137
Practice Address - Street 1:810 CLAIRTON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4567
Practice Address - Country:US
Practice Address - Phone:412-466-5004
Practice Address - Fax:412-466-7137
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449588208000000X
WV390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028693220001Medicaid