Individual
DR. CHRISTOPHER C FORMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 CLAY EDWARDS DR, KANSAS CITY, MO 64116-3220
(816) 691-5201
Mailing address
PO BOX 419380 - DEPT 128, KANSAS CITY, MO 64141-6380
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2006009448
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922019942
—
KS
05
—
200666250A
—
KS
01
—
37226019
BCBSKC
MO
01
—
7406930
AETNA
MO
01
—
P00355712
RR MEDICARE
MO
Enumeration date
08/11/2006
Last updated
12/06/2011
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