Provider Demographics
NPI:1285753517
Name:BARTZ, CHRISTINA MARIE (PAC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:BARTZ
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21639-1469
Mailing Address - Country:US
Mailing Address - Phone:410-482-9148
Mailing Address - Fax:833-914-0405
Practice Address - Street 1:625 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:MD
Practice Address - Zip Code:21639-1469
Practice Address - Country:US
Practice Address - Phone:410-482-9148
Practice Address - Fax:833-914-0405
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002806363A00000X
DEC5-0000428363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
246790ZAXBOtherMEDICARE
MD851015600Medicaid
DERXPA02269OtherDE PRESCRIPTIVE AUTHORITY