Provider Demographics
NPI:1043340185
Name:MAGILL, CHRISTINA BRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:BRAY
Last Name:MAGILL
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 1:3719 E MERIDIAN LOOP STE E
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7273
Mailing Address - Country:US
Mailing Address - Phone:907-671-6017
Mailing Address - Fax:907-631-0766
Practice Address - Street 1:3719 E MERIDIAN LOOP STE E
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7273
Practice Address - Country:US
Practice Address - Phone:907-671-6017
Practice Address - Fax:907-631-0766
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006028765207Y00000X
AKMEDS7503207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology