MEDICARE: CHRISTINA LUEDKE M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0205X	Pediatric Endocrinology Physician	77210	MA

General Provider Information

NPI Number	:	1053383190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LUEDKE M.D., PH.D.

Provider Business Mailing Address
First Line	:	300 LONGWOOD AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-5724
Country	:	US
Telephone Number	:	617-355-7476
Fax Number	:	617-395-2632

Provider Business Practice Location Address
First Line	:	300 LONGWOOD AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-5724
Country	:	US
Telephone Number	:	617-355-6000
Fax Number	:	617-395-2632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	12/04/2023

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