Provider Demographics
NPI:1538168539
Name:DRUMMOND, CHRISTINA C (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:C
Last Name:DRUMMOND
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 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11109 PARKVIEW PLAZA DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1701
Practice Address - Country:US
Practice Address - Phone:260-266-2500
Practice Address - Fax:260-266-2514
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039167A207QH0002X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100347400Medicaid
IN000000648244OtherANTHEM PIN
IN930055877Medicare PIN
INP00742243Medicare PIN
INP01077124Medicare PIN
IN203170GMedicare PIN
IN000000648244OtherANTHEM PIN
INM400058023Medicare PIN
INP00841031Medicare PIN
IN261500AMedicare PIN
IN267350BMedicare PIN
IN261920CMedicare PIN
INE84640Medicare UPIN
INP01120502Medicare PIN