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Individual
DR. CHRISTIAN A PEABODY
Active
Individual
DR. CHRISTIAN A PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901011507
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115070
DENTAL PROVIDER BCBS
MI
05
—
12-3138796
—
MI
05
—
12-4044943
—
MI
01
—
443416
DENTAL PRVDR.# FOR UCCI
MI
01
—
913785
DENTAL PRVDR.# FOR UCCI
MI
Enumeration date
06/28/2005
Last updated
10/27/2015
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