Provider Demographics
NPI:1376036673
Name:POH, CHRISTINA CLARISSA (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CLARISSA
Last Name:POH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 E ANTIETAM ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5701
Mailing Address - Country:US
Mailing Address - Phone:301-790-3620
Mailing Address - Fax:301-797-2863
Practice Address - Street 1:319 E ANTIETAM ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5701
Practice Address - Country:US
Practice Address - Phone:301-790-3620
Practice Address - Fax:301-797-2863
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT018607208000000X
MDH0091624208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics