Provider Demographics
NPI:1336124114
Name:WHITE, CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:WHITE
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 1:136 MILL ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:ME
Mailing Address - Zip Code:04668-3344
Mailing Address - Country:US
Mailing Address - Phone:207-796-5503
Mailing Address - Fax:207-796-5528
Practice Address - Street 1:136 MILL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:ME
Practice Address - Zip Code:04668-3344
Practice Address - Country:US
Practice Address - Phone:207-796-5503
Practice Address - Fax:207-796-5528
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0128322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MERX2835OtherMEDICARE PTAN
MEE67741Medicare UPIN
MERX2835OtherMEDICARE PTAN