MEDICARE: DR. CHRISTOPHER ANTHONY OBUCHOWSKI MD

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
1	2085R0202X	Diagnostic Radiology Physician	MD21355	OR

General Provider Information

NPI Number	:	1356354609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER ANTHONY OBUCHOWSKI MD

Provider Business Mailing Address
First Line	:	10180 SE SUNNYSIDE RD
Second Line	:	KAISER SUNNYSIDE MEDICAL OFFICE
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-9764
Country	:	US
Telephone Number	:	503-904-2568
Fax Number	:	503-571-5869

Provider Business Practice Location Address
First Line	:	10180 SE SUNNYSIDE RD
Second Line	:	KAISER SUNNYSIDE MEDICAL OFFICE
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-9764
Country	:	US
Telephone Number	:	503-904-2568
Fax Number	:	503-571-5869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/17/2007

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