Provider Demographics
NPI:1598709537
Name:KREIDE, CHRISTINE ANDERSON (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANDERSON
Last Name:KREIDE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANDERSON
Other - Last Name:KREIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:125 GRAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4043
Mailing Address - Country:US
Mailing Address - Phone:912-655-2120
Mailing Address - Fax:
Practice Address - Street 1:1370 US HIGHWAY 80 E
Practice Address - Street 2:STE E
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-8902
Practice Address - Country:US
Practice Address - Phone:912-965-9605
Practice Address - Fax:912-965-9604
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT1194152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU10880Medicare UPIN
GA41ZCGCLMedicare PIN