Provider Demographics
NPI:1376771899
Name:PEPITONE, CHRISTA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:MARIE
Last Name:PEPITONE
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 1:618 PONDER PLACE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3117
Mailing Address - Country:US
Mailing Address - Phone:706-760-7607
Mailing Address - Fax:
Practice Address - Street 1:618 PONDER PLACE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3117
Practice Address - Country:US
Practice Address - Phone:706-760-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine