Christiana Medical Group

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

C10008503 Issued in DE

Legal business name

CHRISTIANA MEDICAL GROUP

Practice address

4735 Ogletown Stanton Rd
Map-2, Suite 2201
Newark, DE 19713-2072

Phone

(302) 366-1868

Fax

(302) 366-8572

NPI assigned

Feb 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nana Kutateladze

Title

MD

Phone

(302) 366-1868

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1083741227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "MAP-2, SUITE 2201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-366-1868",
            "fax_number": "302-366-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "MAP-2, SUITE 2201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-366-1868",
            "fax_number": "302-366-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "KUTATELADZE",
        "authorized_official_first_name": "NANA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "302-366-1868"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "DE",
            "license": "C10008503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C10008503",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christiana Dental Spa PA
• Christiana Family Dental Care
• Christiana Family Dental Care Map2 (Christiana Family Dental Care)
• Christiana Gynecologic Oncology, LLC
• Christiana Institute of Advanced Surgery, PA
• Christiana Medical Group, PA
• Christiana Neonatal Associates LLC
• Christiana Nuclear Medicine PA
• Christiana Psychiatric Services PA
• Christiana Spine Ambulatory Surgical Center, LLC

• Hospitalist Physician in Newark, DE
• Providers in Newark, DE by specialty
• Hospitalist Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.