Provider Demographics
NPI:1295120947
Name:CHRISTOPHER, KATINA SERLEMITSOS (MD)
Entity type:Individual
Prefix:DR
First Name:KATINA
Middle Name:SERLEMITSOS
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:KATINA
Other - Last Name:SERLEMITSOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1646 PARK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3155
Mailing Address - Country:US
Mailing Address - Phone:434-654-2760
Mailing Address - Fax:
Practice Address - Street 1:1646 PARK RIDGE DR
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3155
Practice Address - Country:US
Practice Address - Phone:434-654-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD87560207R00000X
VA0101281100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine