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General NPI Number Information
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NPI Number | 1457305682
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Entity Type | Individual
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Provider Name | CHRISTINA A ATHENS P.A.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 HOSPITAL RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4017
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Country | US
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Telephone | 301-855-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 11809 RIVERSHORE DR
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City | DUNKIRK
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State | MD
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Zip | 20754-9441
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Country | US
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Telephone | 410-286-2784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0003137
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License Number State | MD
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