Provider Demographics
NPI:1952308389
Name:MESTEMACHER, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MESTEMACHER
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 1:8110 N BROTHER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2760
Mailing Address - Country:US
Mailing Address - Phone:901-255-5221
Mailing Address - Fax:901-373-4511
Practice Address - Street 1:7918 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1725
Practice Address - Country:US
Practice Address - Phone:901-624-4444
Practice Address - Fax:901-202-4920
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5217633OtherAETNA HMO
TN4341769OtherBCBST MOGA
TN1525451Medicaid
5217633OtherAETNA PPO
TN4155611OtherBCBS
6381105OtherCIGNA
TNP00834375OtherMEDICARE RAILROAD
TNP01172694OtherMEDICARE RAILROAD MOGA
TNP00834375OtherMEDICARE RAILROAD
TN1525451Medicaid