Provider Demographics
NPI:1346257045
Name:PHILLIPS, CHRISTINE A (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:PHILLIPS
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 1:3130 GRANDVIEW RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9134
Mailing Address - Country:US
Mailing Address - Phone:717-633-1978
Mailing Address - Fax:717-632-5961
Practice Address - Street 1:3130 GRANDVIEW RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9134
Practice Address - Country:US
Practice Address - Phone:717-633-1978
Practice Address - Fax:717-632-5961
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038010E207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA667392Medicare ID - Type Unspecified
E82446Medicare UPIN