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NPI 1659959021

NPI 1659959021 : CHRISTINA BAX : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1659959021
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINA BAX
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/29/2021
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    Last Update Date     |    12/19/2025
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Provider Practice Location Address
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    Address Line         |    800 SPRUCE ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19107-6130
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    Country              |    US
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    Telephone            |    240-593-9033
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6201 GREENLEIGH AVE 
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    City                 |    MIDDLE RIVER
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    State                |    MD
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    Zip                  |    21220-2004
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    Country              |    US
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    Telephone            |    410-933-0000
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    Fax                  |    410-500-4266
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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        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    D0104740
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    MD600004999
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    License Number State |    DC
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