MEDICARE: DR. CHRISTINA MARIE STAVITSKI M.D.

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	207R00000X	Internal Medicine Physician		VA

General Provider Information

NPI Number	:	1881887651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA MARIE STAVITSKI M.D.

Provider Business Mailing Address
First Line	:	7950 MARTIN LOOP
Second Line	:	MARTIN ARMY COMMUNITY HOSPITAL
City	:	FT. BENNING
State	:	GA
Zip	:	31905-5637
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7950 MARTIN LOOP
Second Line	:	MARTIN ARMY COMMUNITY HOSPITAL
City	:	FT. BENNING
State	:	GA
Zip	:	31905-5637
Country	:	US
Telephone Number	:	706-544-1245
Fax Number	:

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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