Provider Demographics
NPI:1750302006
Name:ALBA, CRISTIAN D (MD)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:D
Last Name:ALBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 STONER AVENUE
Mailing Address - Street 2:ST 204
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-876-8332
Mailing Address - Fax:410-848-5009
Practice Address - Street 1:295 STONER AVENUE
Practice Address - Street 2:ST 204
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-876-8332
Practice Address - Fax:410-848-5009
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26290207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD460791100Medicaid
MD460791100Medicaid
C49117Medicare UPIN