Healthcare Provider Details

I. General information

NPI: 1225665565
Provider Name (Legal Business Name): CHRISTINA PEDRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA SING-PEDRO MD, MBA

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 EAST BLVD 4TH FLOOR HOSPITALISTS STE
ELKHART IN
46514-2483
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-389-7393
  • Fax: 574-647-1094
Mailing address:
  • Phone: 574-647-3725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01099369A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01099369A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01099369A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: