Provider Demographics
NPI:1114966868
Name:WAITE, CHRISTINA G (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:G
Last Name:WAITE
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 1:1 WYOMING ST STE 1601
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-4250
Mailing Address - Fax:937-208-2911
Practice Address - Street 1:1 WYOMING ST STE 1601
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-4250
Practice Address - Fax:937-208-2911
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0853482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2576869Medicaid
I32891Medicare UPIN
OH4162342Medicare PIN
OHH028152Medicare PIN
OH4162341Medicare PIN