Provider Demographics
NPI:1043731441
Name:UNAEGBU, CHRISTIAN N (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:N
Last Name:UNAEGBU
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 13TH AVE N APT 213
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-5459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2817 REILLY RD
Practice Address - Street 2:FORT BRAGG, NC 28310
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:724-678-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant