Provider Demographics
NPI:1376559500
Name:NETO, CHRISTINE (MD)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:NETO
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 1:10026 OLD OCEAN CITY BLVD
Mailing Address - Street 2:BUILDING ONE
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-208-9761
Mailing Address - Fax:410-208-9764
Practice Address - Street 1:1107 RACETRACK ROAD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-208-9761
Practice Address - Fax:410-208-9764
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045108207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD685000600Medicaid
MD064M890EMedicare ID - Type Unspecified
MD685000600Medicaid