Provider Demographics
NPI:1154412476
Name:CHRISTIE, SARA (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:222 E LINCOLNWAY STE A
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3892
Mailing Address - Country:US
Mailing Address - Phone:219-324-4499
Mailing Address - Fax:219-324-0220
Practice Address - Street 1:222 E LINCOLNWAY STE A
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3892
Practice Address - Country:US
Practice Address - Phone:219-324-4499
Practice Address - Fax:219-324-0220
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01062599A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H80190Medicare UPIN