Provider Demographics
NPI:1760529648
Name:CHRISTIE, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2661 RIVA RD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7353
Mailing Address - Country:US
Mailing Address - Phone:410-224-2880
Mailing Address - Fax:410-224-7828
Practice Address - Street 1:2661 RIVA RD
Practice Address - Street 2:SUITE 610
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7353
Practice Address - Country:US
Practice Address - Phone:410-224-2880
Practice Address - Fax:410-224-7828
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050605174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC611822900OtherDEPARTMENT OF LABOR
P00157968OtherRAILROAD MEDICARE
MD3125734OtherMAMSI UNITEDHEALTHCARE
MD793ACHOtherBCBS OF MARYLAND
496856OtherUNICARE
DCJ710OtherBCBS OF DC
496856OtherNCPPO
1493458OtherCIGNA
MD793ACHOtherBCBS OF MARYLAND
DCJ710OtherBCBS OF DC