Provider Demographics
NPI:1992190870
Name:DILLINGHAM, CHRISTINE L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:DILLINGHAM
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 1:1304 W BOBO NEWSOM HWY
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4710
Mailing Address - Country:US
Mailing Address - Phone:843-339-2100
Mailing Address - Fax:
Practice Address - Street 1:4450 CALIBRE XING NW STE 1126
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4104
Practice Address - Country:US
Practice Address - Phone:470-227-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94858207RN0300X
SD83996207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine