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General NPI Number Information
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NPI Number | 1417055393
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Entity Type | Organization
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Legal Business Name | CHRISTA M GREDLEIN D P M P A
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 100 OWINGS CT SUITE 14
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6428
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Country | US
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Telephone | 410-833-9353
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Fax | 410-833-9550
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Provider Business Mailing Address
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Address Line | 100 OWINGS CT SUITE 14
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6428
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Country | US
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Telephone | 410-833-9353
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Fax | 410-833-9550
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTA MICHELLE GREDLEIN
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Credential | DPM
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Telephone | 410-833-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 01332
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License Number State | MD
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