Provider Demographics
NPI:1063592665
Name:MAX, CHRISTOPHER C (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:C
Last Name:MAX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1676 SUNSET AVE
Mailing Address - Street 2:FAXTON 4TH FLOOR
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5416
Mailing Address - Country:US
Mailing Address - Phone:315-624-8110
Mailing Address - Fax:315-624-8115
Practice Address - Street 1:1676 SUNSET AVE
Practice Address - Street 2:FAXTON 4TH FLOOR
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5416
Practice Address - Country:US
Practice Address - Phone:315-624-8110
Practice Address - Fax:315-624-8115
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-04-17
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Provider Licenses
StateLicense IDTaxonomies
NY148330208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0668Medicare ID - Type Unspecified
D78434Medicare UPIN