Provider Demographics
NPI:1578655270
Name:PAREIGIS, CHRISTINA DIANE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DIANE
Last Name:PAREIGIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 STONEGATE PARK
Mailing Address - Street 2:SUITE #500
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9137
Mailing Address - Country:US
Mailing Address - Phone:269-429-6700
Mailing Address - Fax:269-429-6709
Practice Address - Street 1:3901 STONEGATE PARK
Practice Address - Street 2:SUITE #500
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9137
Practice Address - Country:US
Practice Address - Phone:269-429-6700
Practice Address - Fax:269-429-6709
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051213208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1824978Medicaid
MI1824978Medicaid
0M01770Medicare ID - Type Unspecified