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Individual

DR. CHRISTINE KO BANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2370 MARKET DR, FLEMING ISLAND, FL 32003-4326
(904) 264-6201
(904) 264-6858
Mailing address
7015 A C SKINNER PKWY, SUITE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0101242870
VA
2085R0001X
Radiation Oncology Physician
Primary
ME123077
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014628400
FL
01
150CE
BC/BS
FL
01
382565
AVMED
FL
01
4885776
AETNA
FL
Enumeration date
01/09/2007
Last updated
07/29/2015
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