Individual
MARY ELIZABETH CHRISTIAANSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
30010
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11776
BCBS
NC
05
—
1869031000
—
WV
01
—
26619
PARTNERS
NC
05
—
6701108
—
VA
01
—
7388373
AETNA
NC
05
—
7911776
—
NC
01
—
84312
MEDCOST
NC
05
—
Q3001A
—
SC
Enumeration date
12/06/2005
Last updated
04/22/2008
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