Healthcare Provider Details

I. General information

NPI: 1841247012
Provider Name (Legal Business Name): CHRISTINE J AMIS IV M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 ROUTE 6A SUNFLOWER MKT PLC UNIT N
YARMOUTH PORT MA
02675-2159
US

IV. Provider business mailing address

923 ROUTE 6A SUNFLOWER MKT PLC UNIT N
YARMOUTH PORT MA
02675-2159
US

V. Phone/Fax

Practice location:
  • Phone: 508-360-5195
  • Fax: 508-544-4266
Mailing address:
  • Phone: 508-360-5195
  • Fax: 508-544-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number219518
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: