Provider Demographics
NPI:1235410259
Name:MAUCK, CHRISTINE KLEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:KLEIN
Last Name:MAUCK
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 1:5 HIDDEN PONDS CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2213
Mailing Address - Country:US
Mailing Address - Phone:301-325-5439
Mailing Address - Fax:
Practice Address - Street 1:5 HIDDEN PONDS CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2213
Practice Address - Country:US
Practice Address - Phone:301-325-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00352802083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine