Provider Demographics
NPI:1295029130
Name:CHASE, CRISTIANA COSTA (DO)
Entity Type:Individual
Prefix:
First Name:CRISTIANA
Middle Name:COSTA
Last Name:CHASE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CRISTIANA
Other - Middle Name:ABRANTES
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:DUMC BOX 3961
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 PRATT STREET
Practice Address - Street 2:ABMT CLINIC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-668-1002
Practice Address - Fax:919-668-1091
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014193390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program