Healthcare Provider Details

I. General information

NPI: 1275628398
Provider Name (Legal Business Name): CHRISTOPHER WINTERS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12188B N MERIDIAN ST STE 330
CARMEL IN
46032-4900
US

IV. Provider business mailing address

12188B N MERIDIAN ST STE 330
CARMEL IN
46032-4900
US

V. Phone/Fax

Practice location:
  • Phone: 317-208-3890
  • Fax: 317-575-6909
Mailing address:
  • Phone: 317-208-3890
  • Fax: 317-575-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07000883
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: