Provider Demographics
NPI:1467405787
Name:CHRISTIAN, LISA M (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:MINGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1100 S MONTGOMERY AVE
Mailing Address - Street 2:SUITE 259
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-6330
Mailing Address - Country:US
Mailing Address - Phone:256-383-3372
Mailing Address - Fax:256-386-7109
Practice Address - Street 1:1100 SOUTH MONTGOMERY AVE
Practice Address - Street 2:SUITE 259
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660
Practice Address - Country:US
Practice Address - Phone:256-383-3372
Practice Address - Fax:256-386-7109
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8994207V00000X
ALMD.33730207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010145128OtherBLUE SHIELD
ID57232OtherBLUE CROSS
ID806742900Medicaid
H39511Medicare UPIN
ID000010145128OtherBLUE SHIELD