MEDICARE: DR. CHAD STEVEN CHRISTMAN D.O.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2915	TN
2	207Q00000X	Family Medicine Physician	E-11967	AR
3	207Q00000X	Family Medicine Physician	34.013713	OH
4	207Q00000X	Family Medicine Physician	82824	GA
5	207Q00000X	Family Medicine Physician	17462	CA
6	207Q00000X	Family Medicine Physician	02002518A	IN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	3937240019	OTHER	IN	MEDICARE DMEPOS
7	3937240025	OTHER	IN	MEDICARE DMEPOS
9	P00465452	OTHER	IN	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3519723844004	OTHER	IN	TRICARE
4	7460685	OTHER	IN	AETNA
5	21414	OTHER	IN	PHP
6	000000570560	OTHER	IN	ANTHEM
8	000000513058	OTHER	IN	ANTHEM

NPI Number	:	1841262714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD STEVEN CHRISTMAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 8857
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46898-8857
Country	:	US
Telephone Number	:	260-969-6200
Fax Number	:	260-969-6201

Provider Business Practice Location Address
First Line	:	6819 LIMA RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46818-1145
Country	:	US
Telephone Number	:	260-407-6207
Fax Number	:	260-969-6201

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	09/10/2019

6821 LIMA RD
FORT WAYNE, IN
46818-1145

Practice Phone: 260-704-3922
Practice Fax: 260-232-0007