Provider Demographics
NPI:1245415603
Name:GLAVEY, CHRISTINE PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:PATRICIA
Last Name:GLAVEY
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 1:401 S MAIN ST
Mailing Address - Street 2:SUITE C7
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-1974
Mailing Address - Country:US
Mailing Address - Phone:770-475-2004
Mailing Address - Fax:770-475-9802
Practice Address - Street 1:401 S MAIN ST
Practice Address - Street 2:SUITE C7
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-1974
Practice Address - Country:US
Practice Address - Phone:770-475-2004
Practice Address - Fax:770-475-9802
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI024242207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology