Provider Demographics
NPI:1023539756
Name:CHERIAN, CHRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 PARADISE RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-2514
Mailing Address - Country:US
Mailing Address - Phone:888-224-0804
Mailing Address - Fax:
Practice Address - Street 1:2217 PARADISE RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-2514
Practice Address - Country:US
Practice Address - Phone:888-224-0804
Practice Address - Fax:702-745-0719
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139240207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107238700Medicaid