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NPI Code Detail

MEDICARE: MATTHEW AARON CHRISTIE DO

MEDICARE: MATTHEW AARON CHRISTIE DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry PhysicianSL1450NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720354467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW AARON CHRISTIE DO
Provider Business Mailing Address
First Line : 3014 W CHARLESTON BLVD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-0083
Country : US
Telephone Number : 702-671-5127
Fax Number :
Provider Business Practice Location Address
First Line : 4029 DEAN MARTIN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4138
Country : US
Telephone Number : 702-848-2256
Fax Number : 702-485-6746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2012
Last Update Date : 02/05/2022

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