Individual
CHRISTINA GENSKE TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 260, INDIANAPOLIS, IN 46256
(317) 621-1690
(317) 621-1699
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02003518A
IN
207RI0200X
Infectious Disease Physician
Primary
020003518A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00825447
RR MEDICARE PTAN
IN
01
—
P01214601
RR MEDICARE PTAN
IN
Enumeration date
04/16/2007
Last updated
06/14/2021
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