Healthcare Provider Details

I. General information

NPI: 1164464426
Provider Name (Legal Business Name): CHRISTIANE K KORBA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTIANE K ALEXANDER M.D.

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

IV. Provider business mailing address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

V. Phone/Fax

Practice location:
  • Phone: 636-390-9555
  • Fax: 636-390-0114
Mailing address:
  • Phone: 636-390-9555
  • Fax: 636-390-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number107695
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: