Healthcare Provider Details

I. General information

NPI: 1902848856
Provider Name (Legal Business Name): CHRISTINA LAUDAN AHMADIAN MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA L AHMADIAN MD

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 CROWN DR
CARBONDALE CO
81623-1593
US

IV. Provider business mailing address

1005 W 38TH ST STE 300
AUSTIN TX
78705-1042
US

V. Phone/Fax

Practice location:
  • Phone: 970-366-1029
  • Fax:
Mailing address:
  • Phone: 888-420-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number44610
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: