Provider Demographics
NPI:1629184668
Name:ROBINS, CHRISTINA AUDELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:AUDELL
Last Name:ROBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:777 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 100E
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8705
Mailing Address - Country:US
Mailing Address - Phone:314-475-3126
Mailing Address - Fax:314-475-3127
Practice Address - Street 1:777 S NEW BALLAS RD
Practice Address - Street 2:SUITE 100E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8705
Practice Address - Country:US
Practice Address - Phone:314-475-3126
Practice Address - Fax:314-475-3127
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2000171136207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA83386Medicare UPIN
129430029Medicare PIN
MO000011763Medicare ID - Type Unspecified