Healthcare Provider Details

I. General information

NPI: 1710197256
Provider Name (Legal Business Name): CHRISTA IRENE NAGEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE MAILSTOP MAC 5034, ROOM 7129
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE MACSTOP MAC 5034
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3954
  • Fax: 216-844-7631
Mailing address:
  • Phone: 216-844-3954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.093517
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN5899
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35.093517
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: