# DR. CHRISTOPHER D STREETER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1811968217
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | M-12089 | ID | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | M-12089 | ID | Yes |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 10/31/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | M-12089 | STATE MEDICAL BOARD | ID |