Individual
CHRIST JOHN TICORAS
Active
Individual
CHRIST JOHN TICORAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35-06-3717T
OH
207NS0135X
Procedural Dermatology Physician
35-06-3717T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199905
BCBS
OH
05
—
2146574
—
OH
Enumeration date
08/03/2005
Last updated
06/22/2010
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