Provider Demographics
NPI:1346202884
Name:HERBERT, CHRISTINE V (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:V
Last Name:HERBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:407 EAST AVE
Mailing Address - Street 2:SUITE120
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5299
Mailing Address - Country:US
Mailing Address - Phone:401-725-4700
Mailing Address - Fax:401-725-4740
Practice Address - Street 1:407 EAST AVE
Practice Address - Street 2:SUITE120
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5299
Practice Address - Country:US
Practice Address - Phone:401-725-4700
Practice Address - Fax:401-725-4740
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD7842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
04-07270OtherUNITEDHEALTHCARE
RI004363OtherBLUE CHIP OF RHODE ISLAND
2971OtherNEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND
RI9006581Medicaid
406222OtherTUFTS
5010229OtherAETNA
RI21725-5OtherBLUE SHIELD OF RHODE ISLAND
1346202884OtherCHAMPUS
007010416Medicare ID - Type Unspecified
2971OtherNEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND