Provider Demographics
NPI:1205123338
Name:RUNKEL, CHRISTIN JAMIE (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:JAMIE
Last Name:RUNKEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WOOD DUCK RD
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-7105
Mailing Address - Country:US
Mailing Address - Phone:847-420-0266
Mailing Address - Fax:
Practice Address - Street 1:803 E 68TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4709
Practice Address - Country:US
Practice Address - Phone:912-355-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPOD.618POD213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery