Healthcare Provider Details

I. General information

NPI: 1043345309
Provider Name (Legal Business Name): CHRISTIAN PARISEAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE STE 330
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

V. Phone/Fax

Practice location:
  • Phone: 970-313-2700
  • Fax:
Mailing address:
  • Phone: 614-722-2458
  • Fax: 614-722-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35123774
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35123774
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0055277
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: