Provider Demographics
NPI:1588990451
Name:DAVE, CHRISTINA M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:DAVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:GRONSETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:801 SPRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5701
Mailing Address - Country:US
Mailing Address - Phone:215-829-3396
Mailing Address - Fax:215-829-3661
Practice Address - Street 1:801 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5701
Practice Address - Country:US
Practice Address - Phone:215-829-3396
Practice Address - Fax:215-829-3661
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD472681207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ809446Medicaid