Provider Demographics
NPI:1083626907
Name:DUHAIME, ANN-CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ANN-CHRISTINE
Middle Name:
Last Name:DUHAIME
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 1:55 FRUIT ST # 331
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2696
Mailing Address - Country:US
Mailing Address - Phone:617-643-9175
Mailing Address - Fax:617-726-1866
Practice Address - Street 1:55 FRUIT ST # 331
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-643-9175
Practice Address - Fax:617-724-1866
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245705207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008158Medicaid
NH30201711Medicaid
VT1008158Medicaid
D57914Medicare UPIN