Provider Demographics
NPI:1124283551
Name:VANEGAS, CHRISTIAN Y (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:Y
Last Name:VANEGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 4330
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3937
Mailing Address - Country:US
Mailing Address - Phone:614-255-6900
Mailing Address - Fax:614-255-6901
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 4330
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-255-6913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.015217207R00000X
390200000X
OH35.097616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH028191Medicare PIN