Tisdel, Christopher L

Tisdel, Christopher L is an individual health care provider with primary practice located at 6847 N Chestnut St Ste 105 , Ravenna OH 44266-3929. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Tisdel, Christopher L can be contacted via phone (330) 297-6030.

Contact Information

Primary practice address
6847 N Chestnut St Ste 105 Ravenna OH 44266-3929
Phone: (330) 297-6030
Fax: (330) 297-4919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 081413 Michigan

Profile Details

NPI number 1548239080
LBN Legal business name Tisdel, Christopher L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Dec 18th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548239080 NPPES
Michigan Other 0630027 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 4513256 BLUE CROSS/BLUE SHIELD

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