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Organization

CHRISTIANA SPINE, PA

Active
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Organization

CHRISTIANA SPINE, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAUREN MYERS (OFFICE MANAGER)
(302) 623-4161
Entity
Organization

Contact information

Practice address
4735 OGLETOWN STANTON RD, STE 3302, NEWARK, DE 19713
(302) 623-4144
(302) 623-4289
Mailing address
4735 OGLETOWN STANTON RD, STE 3302, NEWARK, DE 19713
(302) 623-4144
(302) 623-4289

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207X00000X
DE
01
2291480
AETNA/USHC
01
5103889378
BLUE CROSS BLUE SHIELD
DE
01
720356
PERSONAL CHOICE
01
77069000
AMERIHEALTH/KEYSTONE
01
CB6441
RAILROAD MEDICARE
Enumeration date
08/01/2006
Last updated
11/09/2018
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