Provider Demographics
NPI:1154186526
Name:ANUSIM, CHRISTINE CHIAMAKA (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CHIAMAKA
Last Name:ANUSIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 EL PASEO ST APT 35208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3066
Mailing Address - Country:US
Mailing Address - Phone:469-348-8379
Mailing Address - Fax:
Practice Address - Street 1:215 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:FEDERALSBURG
Practice Address - State:MD
Practice Address - Zip Code:21632-1012
Practice Address - Country:US
Practice Address - Phone:410-754-9021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program