Provider Demographics
NPI:1881123891
Name:ESCALANTE, CHRISTINA ROCHELLE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROCHELLE
Last Name:ESCALANTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11090 SERENBE LN STE 320
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-2474
Mailing Address - Country:US
Mailing Address - Phone:470-450-4729
Mailing Address - Fax:470-275-0895
Practice Address - Street 1:11090 SERENBE LN STE 320
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:GA
Practice Address - Zip Code:30268-2474
Practice Address - Country:US
Practice Address - Phone:470-450-4729
Practice Address - Fax:470-275-0895
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89680208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics