Provider Demographics
NPI:1750366829
Name:SHINAVER, CHRISTINA N (MD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:N
Last Name:SHINAVER
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 1:8900 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2118
Mailing Address - Country:US
Mailing Address - Phone:786-596-5917
Mailing Address - Fax:
Practice Address - Street 1:5901 TECHNOLOGY CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-6013
Practice Address - Country:US
Practice Address - Phone:317-328-5050
Practice Address - Fax:317-715-9965
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1540262085N0700X, 2085R0202X
IN01044773A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000368993OtherANTHEM-351158723
IN000000492367OtherANTHEM 203778927
INP00251843OtherRR MEDICARE-351158723
IN062496OtherSIHO-351158723
IN200124720Medicaid
INQ0429607OtherCMOSHO351158723&352047427
IN108063OtherHEALTH ALLIANCE-351158723
INP00251843OtherRR MEDICARE-351158723
ING45697Medicare UPIN