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NPI Code Detail

MEDICARE: CHRISTIAN O VERHAGEN M.D.

MEDICARE:   CHRISTIAN O VERHAGEN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician01039502IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Q0071828OTHERINSHO
3000000081515OTHERINANTHEM

General Provider Information

NPI Number : 1265419394
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN O VERHAGEN M.D.
Provider Business Mailing Address
First Line : PO BOX 775985
Second Line :
City : CHICAGO
State : IL
Zip : 60677-5985
Country : US
Telephone Number : 317-770-6900
Fax Number : 317-770-6911
Provider Business Practice Location Address
First Line : 205 NOBLE CREEK DR
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-3117
Country : US
Telephone Number : 317-773-8483
Fax Number : 317-776-0442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 09/22/2020

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Directions to “ CHRISTIAN O VERHAGEN M.D.” Practice Location

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