Provider Demographics
NPI:1306836853
Name:OGILVY, CHRISTOPHER S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:OGILVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 FRANCIS ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5501
Mailing Address - Country:US
Mailing Address - Phone:617-632-7246
Mailing Address - Fax:617-632-0949
Practice Address - Street 1:110 FRANCIS ST STE 3B
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5501
Practice Address - Country:US
Practice Address - Phone:617-632-7246
Practice Address - Fax:617-632-0949
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA73618207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ10512OtherBCBS MA
MA3075788Medicaid
MA721687OtherTUFTS HEALTH PLAN
E69517Medicare UPIN
MAJ10512Medicare ID - Type Unspecified