Provider Demographics
NPI:1356371058
Name:OLESON, CHRISTINA V (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:V
Last Name:OLESON
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 1:2500 METROHEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-7800
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35132079208100000X
NH14137208100000X, 2081P0004X
AL26108208100000X
PAMD4171002081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009959705Medicaid
AL051523455OtherBLUE CROSS
AL009960735Medicaid
NJ0235369Medicaid
AL051523456OtherBLUE CROSS
PA102480079Medicaid
PA102480079Medicaid
ALP00263783Medicare PIN
AL051523455OtherBLUE CROSS
NH000796401Medicare PIN