Healthcare Provider Details

I. General information

NPI: 1659566479
Provider Name (Legal Business Name): CHRISTOPHER S VARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 RADIO DRIVE SUITE 100
WOODBURY MN
55125-5817
US

IV. Provider business mailing address

215 RADIO DRIVE SUITE 100
WOODBURY MN
55125-3604
US

V. Phone/Fax

Practice location:
  • Phone: 612-596-6100
  • Fax: 612-339-0324
Mailing address:
  • Phone: 612-596-6100
  • Fax: 612-339-0324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number59606
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number13823
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number036.146988
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number2018024524
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number28649
License Number StateNE
# 6
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number9608
License Number StateSD
# 7
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberM8401
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number64158-20
License Number StateWI
# 9
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberMD-42802
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: