Provider Demographics
NPI:1932580206
Name:ERWIN, CHRISTOPHER DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DANIEL
Last Name:ERWIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3111
Mailing Address - Country:US
Mailing Address - Phone:740-373-2069
Mailing Address - Fax:740-336-7887
Practice Address - Street 1:111 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3111
Practice Address - Country:US
Practice Address - Phone:740-373-2069
Practice Address - Fax:740-336-7887
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6372152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist