Provider Demographics
NPI:1043443351
Name:CUNDIFF, KRISTINA A (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:A
Last Name:CUNDIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:A
Other - Last Name:MROWCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:456 W 10TH AVE
Mailing Address - Street 2:4510 CRAMBLET HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1240
Mailing Address - Country:US
Mailing Address - Phone:614-293-3551
Mailing Address - Fax:
Practice Address - Street 1:456 W 10TH AVE
Practice Address - Street 2:4510 CRAMBLET HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.016201207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine