Provider Demographics
NPI:1669948501
Name:REID CHRISTIE DPM PLLC
Entity type:Organization
Organization Name:REID CHRISTIE DPM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:ALEC
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:317-753-5117
Mailing Address - Street 1:7 TROLLEY CAR LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2932
Mailing Address - Country:US
Mailing Address - Phone:317-753-5117
Mailing Address - Fax:
Practice Address - Street 1:41 BUTTRICK RD STE 5
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3367
Practice Address - Country:US
Practice Address - Phone:317-753-5117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH0358OtherSTATE LICENSE