Provider Demographics
NPI:1700856374
Name:ANDIA RABO, CRISTINA A (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:A
Last Name:ANDIA RABO
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 1:5409 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:FT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627
Mailing Address - Country:US
Mailing Address - Phone:319-376-2134
Mailing Address - Fax:319-376-2188
Practice Address - Street 1:5409 AVENUE O
Practice Address - Street 2:
Practice Address - City:FT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627
Practice Address - Country:US
Practice Address - Phone:319-376-2134
Practice Address - Fax:319-376-2188
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20862207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0175133Medicaid
IA1700856374Medicaid
IA511790009Medicare PIN
IA0175133Medicaid
13983Medicare ID - Type Unspecified