MEDICARE: ADWOA CHRISTY 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	207V00000X	Obstetrics & Gynecology Physician	A87224	CA

General Provider Information

NPI Number	:	1225017379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADWOA CHRISTY MD

Provider Business Mailing Address
First Line	:	2907 CHANTICLEER AVE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95065-1815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2907 CHANTICLEER AVE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95065-1815
Country	:	US
Telephone Number	:	831-477-2375
Fax Number	:

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	01/05/2012

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