Healthcare Provider Details

I. General information

NPI: 1831310606
Provider Name (Legal Business Name): CHRISTINA ROSE ANSLINGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 MIAMI VALLEY DR STE 310
CENTERVILLE OH
45459-4778
US

IV. Provider business mailing address

3170 KETTERING BLVD. BLDG. B THIRD FLOOR
DAYTON OH
45439-1924
US

V. Phone/Fax

Practice location:
  • Phone: 937-438-5216
  • Fax: 937-438-5229
Mailing address:
  • Phone: 937-991-3188
  • Fax: 937-223-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34009655
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number34009655
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: