Provider Demographics
NPI:1467615344
Name:CHRISTIANO, LANA DAWN (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:DAWN
Last Name:CHRISTIANO
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 1:415 MORRIS ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1842
Mailing Address - Country:US
Mailing Address - Phone:304-344-3551
Mailing Address - Fax:304-342-6927
Practice Address - Street 1:415 MORRIS ST
Practice Address - Street 2:SUITE 400
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1842
Practice Address - Country:US
Practice Address - Phone:304-344-3551
Practice Address - Fax:304-342-6927
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV24790207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV1364AOtherMEDICARE PTAN
WV3810023317Medicaid