MEDICARE: DR. CHRISTOPHER JAMES PATITSAS 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	207W00000X	Ophthalmology Physician	MD041833L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	608474	OTHER	PA	BLUE SHIELD
2	1811466	OTHER	PA	BLUE SHIELD
3	251634705	OTHER	PA	TRICARE

General Provider Information

NPI Number	:	1831194497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JAMES PATITSAS M.D.

Provider Business Mailing Address
First Line	:	1227 WARM SPRINGS AVE
Second Line	:	STE 303
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-2300
Country	:	US
Telephone Number	:	814-643-5660
Fax Number	:	814-643-5667

Provider Business Practice Location Address
First Line	:	1227 WARM SPRINGS AVE
Second Line	:	STE 303
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-2300
Country	:	US
Telephone Number	:	814-643-5660
Fax Number	:	814-643-5667

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/20/2008

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