Provider Demographics
NPI:1073558573
Name:DULL, CHRISTINE MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARIE
Last Name:DULL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 S US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-2846
Mailing Address - Country:US
Mailing Address - Phone:251-580-0481
Mailing Address - Fax:251-580-0483
Practice Address - Street 1:106 S US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-2846
Practice Address - Country:US
Practice Address - Phone:251-580-0481
Practice Address - Fax:251-580-0483
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL275213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51556716Medicare ID - Type Unspecified
ALU94488Medicare UPIN
AL5532480001Medicare NSC