Provider Demographics
NPI:1316276140
Name:UMHAU, JOHN CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:UMHAU
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 1:200 WEST HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941-0860
Mailing Address - Country:US
Mailing Address - Phone:928-338-3555
Mailing Address - Fax:928-338-5508
Practice Address - Street 1:200 WEST HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941
Practice Address - Country:US
Practice Address - Phone:928-338-3555
Practice Address - Fax:928-338-5508
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD28090207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HSZ962RBUOtherWHITERIVER
AZ846790Medicaid
AZ020561Medicaid
AZ020561Medicaid
E7650Medicare UPIN
HSZ962RBUOtherWHITERIVER