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General NPI Number Information
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NPI Number | 1639138894
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Entity Type | Individual
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Provider Name | CHRISTINE L GATES MD
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 259 MAIN ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6723
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Country | US
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Telephone | 207-874-1489
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Fax | 207-523-8590
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Provider Business Mailing Address
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Address Line | 100 GANNETT DR SUITE C
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-5900
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Country | US
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Telephone | 207-828-0361
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Fax | 207-874-1483
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 016164
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License Number State | ME
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