Provider Demographics
NPI:1609039882
Name:MIN, CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:MIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:148 BILL CARRUTH PKWY
Mailing Address - Street 2:SUITE LL30
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-3754
Mailing Address - Country:US
Mailing Address - Phone:770-505-3855
Mailing Address - Fax:770-443-6654
Practice Address - Street 1:148 BILL CARRUTH PKWY
Practice Address - Street 2:SUITE LL30
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3754
Practice Address - Country:US
Practice Address - Phone:770-505-3855
Practice Address - Fax:770-443-6654
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2019-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2572702085R0001X
GA698312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology