Provider Demographics
NPI:1407819220
Name:GEST, CHRISTINE R (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:GEST
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 1:4015 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:4015 GATEWAY BLVD
Practice Address - Street 2:SUITE 2120
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8925
Practice Address - Country:US
Practice Address - Phone:812-842-0907
Practice Address - Fax:812-490-7054
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036382A207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100343810AMedicaid
000000042525OtherANTHEM
IL313668237Medicaid
KY64877418Medicaid
ILL65376Medicare PIN
000000042525OtherANTHEM
F55818Medicare UPIN
IL313668237Medicaid
IL313668237Medicaid