Provider Demographics
NPI:1154534170
Name:BALIGA, CHRISTOPHER SURESH (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SURESH
Last Name:BALIGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-341-0846
Mailing Address - Fax:206-223-6814
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-341-0846
Practice Address - Fax:206-223-6814
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60021345207R00000X, 207RI0200X, 208M00000X
TXN7055207R00000X, 207RI0200X, 208M00000X
UT8122269-1205207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218941702Medicaid
TX1154534170OtherBLUE CROSS BLUE SHIELD
TXP01030936OtherRR MEDICARE
LA2163566Medicaid
UTP01059124OtherRR PTAN (IHC)
TX218941701Medicaid
TXP00949799OtherMEDICARE RR
UTP01059124OtherRR PTAN (IHC)
TX218941701Medicaid
TXTXB116712Medicare PIN
WAG8918951Medicare PIN
WAG8918175Medicare PIN