Provider Demographics
NPI:1205876976
Name:REESE, CHRISTOPHER S (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:18099 LORAIN AVE
Mailing Address - Street 2:SUITE 141
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5610
Mailing Address - Country:US
Mailing Address - Phone:216-941-0333
Mailing Address - Fax:216-941-5257
Practice Address - Street 1:18099 LORAIN AVE
Practice Address - Street 2:SUITE 141
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5610
Practice Address - Country:US
Practice Address - Phone:216-941-0333
Practice Address - Fax:216-941-1071
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-068471208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0167359Medicaid
OHUR9354701OtherGROUP MEDICARE PIN #
OHUR9354701OtherGROUP MEDICARE PIN #
OH0167359Medicaid