Basic Information
| Provider Information | |||||||||
| NPI: | 1336179035 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRISTEA | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 270 EDGEWOOD CT | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863035301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287769787 | ||||||||
| FaxNumber: | 9287766147 | ||||||||
| Practice Location | |||||||||
| Address1: | VETERANS HOSPITAL | ||||||||
| Address2: | 500 N HIGHWAY 89 | ||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 86313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9284454860 | ||||||||
| FaxNumber: | 9287766147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 10460 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.