Provider Demographics
NPI:1740277813
Name:CAREY, CHRISTINE A (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:A
Last Name:CAREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 SOUTH ST
Mailing Address - Street 2:SUITE G05
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-4051
Mailing Address - Country:US
Mailing Address - Phone:508-765-5981
Mailing Address - Fax:508-764-4637
Practice Address - Street 1:100 SOUTH ST
Practice Address - Street 2:SUITE G05
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4051
Practice Address - Country:US
Practice Address - Phone:508-765-5981
Practice Address - Fax:508-764-4637
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150497207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3154556Medicaid
MA3154556Medicaid
MAA21655Medicare ID - Type Unspecified