Provider Demographics
NPI:1205822533
Name:HULSEY, CHRISTOPHER ANDRE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDRE
Last Name:HULSEY
Suffix:
Gender:M
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:PO BOX 15759
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2459
Mailing Address - Country:US
Mailing Address - Phone:912-355-8188
Mailing Address - Fax:912-356-6970
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-8436
Practice Address - Fax:912-356-6970
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0532462085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG53246Medicaid
GAN343827OtherWELLCARE
GA108709597BMedicaid
GA52703766002OtherBCBS
GA108709597BOtherPEACH STATE HEALTH PLAN
GAP00269230OtherRAILROAD MEDICARE
GAN343827OtherWELLCARE
GA108709597BMedicaid