| Doctor Name: | DR. CHRISTOPHER MERLE NYSTUEN |
| NPI Number: | 1528107372 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C54117 |
| Business Practice Address: | 1650 Cochrane Cir Department Of Medical Readiness Ft Carson, CO - 809134613 |
| Business Phone Number: | 7195247351 |
| Business Fax Number: | |
| Mailing Address: | 1650 Cochrane Cir, FT CARSON |
| State: | CO |
| Postal Code: | 809134613 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 09/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C54117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |