Healthcare Provider Details

I. General information

NPI: 1083937353
Provider Name (Legal Business Name): CHRISTINE MARIE OLANREWAJU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE MARIE NEUBERT D.O.

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 11/03/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DR. HITZELBERGER STRASSE
LANDSTUHL DC
09180
US

IV. Provider business mailing address

401 SARAH DR
CLARKSVILLE TN
37042-3793
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-5758
  • Fax:
Mailing address:
  • Phone: 614-264-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number02003989A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number02003989A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: