MEDICARE: DONNA-MARIE E CHRISTIE M.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	207R00000X	Internal Medicine Physician	223127	MA
2	207R00000X	Internal Medicine Physician	044081	CT

General Provider Information

NPI Number	:	1124075874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA-MARIE E CHRISTIE M.D.

Provider Business Mailing Address
First Line	:	2110 SILAS DEANE HWY
Second Line	:
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-2313
Country	:	US
Telephone Number	:	860-258-3470
Fax Number	:	860-571-6800

Provider Business Practice Location Address
First Line	:	18 EAST GRANBY RD
Second Line	:
City	:	GRANBY
State	:	CT
Zip	:	06035-2201
Country	:	US
Telephone Number	:	860-653-7261
Fax Number	:	860-653-6639

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	01/24/2014

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