Provider Demographics
NPI:1417999814
Name:MERCHANT, CHRISTOPHER S (PA C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:S
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 15TH AVE S
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4324
Mailing Address - Country:US
Mailing Address - Phone:406-455-3650
Mailing Address - Fax:406-455-3695
Practice Address - Street 1:500 15TH AVE S
Practice Address - Street 2:SUITE 1
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4324
Practice Address - Country:US
Practice Address - Phone:406-455-3650
Practice Address - Fax:406-455-3695
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT00092583OtherBLUE CROSS BLUE SHIELD
MT184609700OtherFEDERAL WORK COMP
MT0434741Medicaid
MT810347861009OtherEBMS
MT970013232OtherRAILROAD MEDICARE
MT810347861OtherCHAMPUS
MT0206210OtherWASHINGTON L & I
MT810347861OtherCHAMPUS
MT0206210OtherWASHINGTON L & I
MTS23511Medicare UPIN