Provider Demographics
NPI:1093814303
Name:MCCANN, CHRISTA RIGEL (MD)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:RIGEL
Last Name:MCCANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:864-364-6380
Mailing Address - Fax:833-853-9422
Practice Address - Street 1:366 MARKET ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0926
Practice Address - Country:US
Practice Address - Phone:643-646-3808
Practice Address - Fax:833-853-9422
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC25863207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCE989L064OtherMEDICARE
SCP00615799OtherRR MEDICARE
SCP00615799OtherRR MEDICARE
SCI27238Medicare UPIN