MEDICARE: DR. CHRISTINA COLLURA DO, MPH

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	207K00000X	Allergy & Immunology Physician	DO82952	SC
2	207K00000X	Allergy & Immunology Physician	2009-01137	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336110386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA COLLURA DO, MPH

Provider Business Mailing Address
First Line	:	15634 KNOX HILL RD
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5690
Country	:	US
Telephone Number	:	704-775-2447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 E 7TH ST UNIT A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-4398
Country	:	US
Telephone Number	:	704-372-7900
Fax Number	:

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

Provider Enumeration Date	:	01/29/2006
Last Update Date	:	01/18/2023

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