Provider Demographics
NPI:1629119474
Name:TUMACDER, CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:TUMACDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:C
Other - Middle Name:
Other - Last Name:TUMACDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD PC
Mailing Address - Street 1:1435 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1386
Mailing Address - Country:US
Mailing Address - Phone:219-440-7375
Mailing Address - Fax:219-515-6968
Practice Address - Street 1:1435 EAGLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1386
Practice Address - Country:US
Practice Address - Phone:219-440-7375
Practice Address - Fax:219-515-6968
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047018A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200153390Medicaid