Provider Demographics
NPI:1598820417
Name:GOULD, CHRISTINE MAE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MAE
Last Name:GOULD
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE ROAD
Mailing Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Mailing Address - City:MCHK-QS TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-1252
Mailing Address - Fax:808-433-1252
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Practice Address - City:MCHK-QS TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-2460
Practice Address - Fax:808-433-1558
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2021-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD- 13869208000000X
HIMD-138692080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN