Provider Demographics
NPI:1427069863
Name:SAMATHANAM, CHRISTINA A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:SAMATHANAM
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:401 WEST SECOND ST.
Mailing Address - Street 2:NELSON/227/MAIL STOP 353
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-0353
Mailing Address - Country:US
Mailing Address - Phone:775-784-1223
Mailing Address - Fax:775-327-2006
Practice Address - Street 1:1664 NORTH VIRGINIA STREET
Practice Address - Street 2:MAIL STOP 350
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557
Practice Address - Country:US
Practice Address - Phone:775-784-4068
Practice Address - Fax:775-784-1636
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
TX41404207ZP0102X
NV14323207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBS8231223OtherDEA