Provider Demographics
NPI:1790723807
Name:STABLER, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STABLER
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 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:SUITE 11
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025170E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP002761OtherGATEWAY
PA000980780 0005Medicaid
PA5947353OtherAETNA-NON HMO
PA20038878OtherMERCY
PA0038352000OtherINDEPENDENCE BLUE CROSS
PA000000138663-HBPOtherUNISON
PA1419124OtherAETNA-HMO
PA30013094OtherKEYSTONE MERCY
PA50056065OtherCAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
PA080073251OtherRR MEDICARE
PA000100026OtherHIGHMARK
PA000000127946-PCPOtherUNISON
PA172660OtherHEALTHAMERICA
PA1419124OtherAETNA-HMO
PA100026Medicare ID - Type Unspecified