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General NPI Number Information
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NPI Number | 1548748957
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEE PAIK MD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 107 N STONE ST ST A
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City | DELAND
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State | FL
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Zip | 32720
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Country | US
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Telephone | 386-943-4522
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 E HUBBARD AVE
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City | DELAND
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State | FL
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Zip | 32724-6122
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Country | US
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Telephone | 787-487-4974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33804R
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 146344
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License Number State | FL
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