Provider Demographics
NPI:1225564511
Name:GANDY, CHRISTIANA LOREDANA (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:LOREDANA
Last Name:GANDY
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 1:800 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-4754
Mailing Address - Country:US
Mailing Address - Phone:715-261-8500
Mailing Address - Fax:715-261-8667
Practice Address - Street 1:800 N 1ST ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-4754
Practice Address - Country:US
Practice Address - Phone:715-261-8500
Practice Address - Fax:715-261-8667
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI77093-20207WX0009X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist