Provider Demographics
NPI:1245259019
Name:CHRISTIAN, HORACE DELBERT II (MD)
Entity type:Individual
Prefix:
First Name:HORACE
Middle Name:DELBERT
Last Name:CHRISTIAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0358
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:2500 W STRUB RD
Practice Address - Street 2:SUITE 230
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5366
Practice Address - Country:US
Practice Address - Phone:419-626-6891
Practice Address - Fax:419-626-8009
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056517174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0947971Medicaid
OH0947971Medicaid
PAF02543Medicare UPIN