Provider Demographics
NPI:1649407651
Name:STAUB, CHRISTINE ELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ELLA
Last Name:STAUB
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 1:7737 PEARMAN QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-8751
Mailing Address - Country:US
Mailing Address - Phone:336-643-3124
Mailing Address - Fax:
Practice Address - Street 1:7737 PEARMAN QUARRY RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-8751
Practice Address - Country:US
Practice Address - Phone:336-643-3124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine