Provider Demographics
NPI:1144209123
Name:DELORIE, CHRISTOPHER J (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:DELORIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:519 US ROUTE 1
Mailing Address - Street 2:UNIT 9
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909
Mailing Address - Country:US
Mailing Address - Phone:207-363-4114
Mailing Address - Fax:207-363-4126
Practice Address - Street 1:519 US ROUTE 1
Practice Address - Street 2:UNIT 9
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909
Practice Address - Country:US
Practice Address - Phone:207-363-4114
Practice Address - Fax:207-363-4126
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1853208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME1358Medicare PIN