Provider Demographics
NPI:1215932645
Name:CHRISTMAN, KATHY LYN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:LYN
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 SUTLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4721
Mailing Address - Country:US
Mailing Address - Phone:912-354-6187
Mailing Address - Fax:912-355-9807
Practice Address - Street 1:100 BUCKWALTER PLACE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5023
Practice Address - Country:US
Practice Address - Phone:843-836-7120
Practice Address - Fax:843-815-8014
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC18666207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC186667Medicaid
SC6526Medicare PIN
SC186667Medicaid