Basic Information
| Provider Information | |||||||||
| NPI: | 1134173032 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMLING | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | M.D., F.A.C.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3303 SW BOND AVE, MAIL CODE CH10U | ||||||||
| Address2: | OHSU, UROLOGY | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034189132 | ||||||||
| FaxNumber: | 5033461501 | ||||||||
| Practice Location | |||||||||
| Address1: | 3303 SW BOND AVE, MAIL CODE CH10U | ||||||||
| Address2: | OHSU, UROLOGY | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034189132 | ||||||||
| FaxNumber: | 5033461501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2006 | ||||||||
| LastUpdateDate: | 11/01/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 26881 | AL | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | MD29001 | OR | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 009934508 | 05 | AL | MEDICAID | 051530720 | 01 | AL | BLUE CROSS | OTHER | 08335584 | 01 | MS | MISSISSIPPI MEDICAID | OTHER | P00253526 | 01 | AL | RAILROAD MEDICARE | OTHER | D73083 | 01 | AL | VIVA | OTHER | 009933011 | 05 | AL | MEDICAID | 009934507 | 05 | AL | MEDICAID | 051530722 | 01 | AL | BLUE CROSS | OTHER | 07026095 | 01 | MS | MISSISSIPPI MEDICAID | OTHER | 051530721 | 01 | AL | BLUE CROSS | OTHER |