Provider Demographics
NPI:1114030012
Name:GOSCH, CHRISTINE H (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:H
Last Name:GOSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 BRANSON LANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2052
Mailing Address - Country:US
Mailing Address - Phone:417-335-7218
Mailing Address - Fax:
Practice Address - Street 1:2500 BELLVU MED CTR DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1591
Practice Address - Country:US
Practice Address - Phone:402-763-3035
Practice Address - Fax:402-763-3194
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103341207P00000X
NE29809207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207783549Medicaid
G01683Medicare UPIN
515050041Medicare PIN