Provider Demographics
NPI:1801000633
Name:WEBB, CHRISTINA D (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:D
Last Name:WEBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:97 GREAT TEAYS BLVD
Mailing Address - Street 2:STE 6
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9815
Mailing Address - Country:US
Mailing Address - Phone:304-757-6999
Mailing Address - Fax:304-757-3252
Practice Address - Street 1:97 GREAT TEAYS BLVD
Practice Address - Street 2:STE 6
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9815
Practice Address - Country:US
Practice Address - Phone:304-757-6999
Practice Address - Fax:304-757-3252
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV22969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9455381OtherAETNA
WV613918800OtherBLACK LUNG/FECA
KY7100083430Medicaid
WV3810015407Medicaid
OH3002057Medicaid
WVWV1067FMedicare PIN
WV613918800OtherBLACK LUNG/FECA
WV4271351Medicare PIN
WVWV1067FMedicare PIN