Basic Information
Provider Information
NPI: 1568559888
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: USSHER
FirstName: CHRISTOPHER
MiddleName: NEVILLE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2261 DOUGLAS BLVD
Address2:  
City: ROSEVILLE
State: CA
PostalCode: 956613831
CountryCode: US
TelephoneNumber: 8314234111
FaxNumber:  
Practice Location
Address1: 3100 KENNARD ST
Address2:  
City: MAPLEWOOD
State: MN
PostalCode: 551095465
CountryCode: US
TelephoneNumber: 6507372692
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2006
LastUpdateDate: 08/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XA52359CAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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