Provider Demographics
NPI:1205416906
Name:LUCIDO, CHRISTOPHER THOMAS (MD/PHD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:LUCIDO
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 W 66TH ST
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2532
Mailing Address - Country:US
Mailing Address - Phone:952-920-3808
Mailing Address - Fax:952-920-8899
Practice Address - Street 1:3316 W 66TH ST
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2532
Practice Address - Country:US
Practice Address - Phone:952-920-3808
Practice Address - Fax:952-920-8899
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program