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General NPI Number Information
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NPI Number | 1609884956
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Entity Type | Individual
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Provider Name | CHRISTA M. GREDLEIN D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 4821 BUTLER RD STE 2D
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City | GLYNDON
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State | MD
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Zip | 21136-5688
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Country | US
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Telephone | 410-833-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 515 FAIRMOUNT AVE STE 400
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City | TOWSON
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State | MD
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Zip | 21286-8518
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Country | US
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Telephone | 410-833-9353
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Fax | 410-584-1873
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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 | 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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