Provider Demographics
NPI:1144214487
Name:CHRISTMAN, LISA ABERNETHY (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ABERNETHY
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:LISA
Other - Last Name:ABERNETHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1306 CONCOURSE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1033
Mailing Address - Country:US
Mailing Address - Phone:919-782-2152
Mailing Address - Fax:919-876-2351
Practice Address - Street 1:800 SPRINGFIELD COMMONS DR STE 115
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8533
Practice Address - Country:US
Practice Address - Phone:919-876-3656
Practice Address - Fax:919-876-2351
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400184207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910189Medicaid
2200880AMedicare ID - Type Unspecified
F84374Medicare UPIN