Provider Demographics
NPI:1770570046
Name:DALEY, CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:DALEY
Suffix:
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 1:555 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-6312
Mailing Address - Country:US
Mailing Address - Phone:970-586-2317
Mailing Address - Fax:970-586-0684
Practice Address - Street 1:555 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-6312
Practice Address - Country:US
Practice Address - Phone:970-586-2317
Practice Address - Fax:970-586-0684
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30918207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01309186Medicaid
CO01309186Medicaid
COCL5318Medicare Oscar/Certification
CO15318Medicare ID - Type Unspecified