Provider Demographics
NPI:1619003142
Name:VETTER, CHRISTINE LYNNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LYNNETTE
Last Name:VETTER
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 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-263-8340
Practice Address - Fax:608-833-0999
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272944207U00000X, 2085R0202X
CT051566207U00000X
WI38477-202085R0202X
CT515662085R0202X
WI384772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAP270SMedicare PIN
CAAP270TMedicare PIN
CAP00656304Medicare PIN
CAAP270ZMedicare PIN
CABE229YMedicare PIN
CAAP270VMedicare PIN
CAAP270UMedicare PIN
CAAP270YMedicare PIN
CAAP270WMedicare PIN
CAAP270RMedicare PIN
CABE229XMedicare PIN
CA00G841350Medicare PIN
CAAP270XMedicare PIN