Provider Demographics
NPI:1376521955
Name:CHRISTIE, JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:47149 BUSE RD
Mailing Address - Street 2:BLDG 1370
Mailing Address - City:PATUXENT RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:20670-1540
Mailing Address - Country:US
Mailing Address - Phone:301-342-9503
Mailing Address - Fax:301-342-4718
Practice Address - Street 1:47149 BUSE RD
Practice Address - Street 2:BLDG 1370
Practice Address - City:PATUXENT RIVER
Practice Address - State:MD
Practice Address - Zip Code:20670-1540
Practice Address - Country:US
Practice Address - Phone:301-342-9503
Practice Address - Fax:301-342-4718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY178649-12083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN