MEDICARE: CHRISTOPHER NEVILLE USSHER M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	A52359	CA

General Provider Information

NPI Number	:	1568559888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER NEVILLE USSHER M.D.

Provider Business Mailing Address
First Line	:	2261 DOUGLAS BLVD
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-3831
Country	:	US
Telephone Number	:	831-423-4111
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 KENNARD ST
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-5465
Country	:	US
Telephone Number	:	650-737-2692
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/10/2016

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