Healthcare Provider Details

I. General information

NPI: 1578832309
Provider Name (Legal Business Name): CHRISTINA CHRISMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2011
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E MCDOWELL RD
PHOENIX AZ
85006-2506
US

IV. Provider business mailing address

755 E MCDOWELL RD
PHOENIX AZ
85006-2506
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3300
  • Fax: 602-521-3246
Mailing address:
  • Phone: 602-521-3300
  • Fax: 602-521-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number125059954
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberR73595
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number52127
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number52127
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberA131812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: