Provider Demographics
NPI:1407942493
Name:RODRIGUEZ, CHRISTIAN COELLO (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:COELLO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MEDICAL CENTER DR STE 2500
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2667
Mailing Address - Country:US
Mailing Address - Phone:207-373-6155
Mailing Address - Fax:207-808-7761
Practice Address - Street 1:121 MEDICAL CENTER DR STE 2500
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2667
Practice Address - Country:US
Practice Address - Phone:207-373-6155
Practice Address - Fax:207-808-7761
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD29604208600000X, 2086S0129X
NH128172086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y008576NH01OtherANTHEM BC/BS
020456218OtherCOMMERCIAL
NH30205247Medicaid
I12163Medicare UPIN
NHRE8397Medicare ID - Type Unspecified