Healthcare Provider Details

I. General information

NPI: 1629271374
Provider Name (Legal Business Name): CHRISTINE KATHRYN HARRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE KATHRYN ZOON M.D.

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 BANK CT STE 110
FREDERICK MD
21703-8479
US

IV. Provider business mailing address

PO BOX 37086
BALTIMORE MD
21297-3086
US

V. Phone/Fax

Practice location:
  • Phone: 301-418-6611
  • Fax: 240-439-8910
Mailing address:
  • Phone: 240-439-8913
  • Fax: 240-439-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD81219
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberD81219
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: