Provider Demographics
NPI:1770041485
Name:DOUGLAS, CHRISTOPHER MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:DOUGLAS
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 1:8200 E BELLEVIEW AVE STE 270E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2882
Mailing Address - Country:US
Mailing Address - Phone:303-649-3710
Mailing Address - Fax:303-649-3711
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 270E
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2882
Practice Address - Country:US
Practice Address - Phone:303-649-3710
Practice Address - Fax:303-649-3711
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.5700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant