Healthcare Provider Details

I. General information

NPI: 1639690266
Provider Name (Legal Business Name): CHRISTINA HARRIS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8091 TOWNSHIP LINE RD STE 206
INDIANAPOLIS IN
46260-2495
US

IV. Provider business mailing address

11595 N MERIDIAN ST STE 375
CARMEL IN
46032-3950
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-1000
  • Fax: 317-415-1010
Mailing address:
  • Phone: 317-575-7304
  • Fax: 317-575-7333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number02006377A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: