MEDICARE: DR. CHRISTINA MARIE KEIGER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	16435	SC

General Provider Information

NPI Number	:	1104847938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA MARIE KEIGER MD

Provider Business Mailing Address
First Line	:	2720 SUNSET BLVD
Second Line	:	ATTN: MANAGED CARE DEPT.
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-4810
Country	:	US
Telephone Number	:	803-791-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7035 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-1177
Country	:	US
Telephone Number	:	803-749-0924
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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