Provider Demographics
NPI:1992788624
Name:MINRATH, CHRISTINA M (MD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:MINRATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 HIGHLANDER POINT DR
Mailing Address - Street 2:STE 300
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9465
Mailing Address - Country:US
Mailing Address - Phone:812-923-4106
Mailing Address - Fax:812-923-4100
Practice Address - Street 1:800 HIGHLANDER POINT DR
Practice Address - Street 2:STE 300
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9465
Practice Address - Country:US
Practice Address - Phone:812-923-4106
Practice Address - Fax:812-923-4100
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059442A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200488760Medicaid
IN243940GMedicare ID - Type Unspecified