Provider Demographics
NPI:1548276975
Name:BLICHARSKI, CHRISTOPHER K (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:BLICHARSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KRZYSZTOF
Other - Middle Name:K
Other - Last Name:BLICHARSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:CONIFER BUILDING, SUITE 210
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:803-431-9093
Mailing Address - Fax:
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:CONIFER BUILDING, SUITE 210
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:803-431-9093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC16912Medicaid
SC16912Medicaid