MEDICARE: DR. MAISLYN ANNMARIE 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	208000000X	Pediatrics Physician	D38739	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	KW0CH5	OTHER		BCBS MD
2	B846	OTHER		BCBS OF NCA

General Provider Information

NPI Number	:	1619952728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAISLYN ANNMARIE CHRISTIE M.D.

Provider Business Mailing Address
First Line	:	2309 GOLD MINE RD
Second Line	:
City	:	BROOKEVILLE
State	:	MD
Zip	:	20833-2233
Country	:	US
Telephone Number	:	301-570-3459
Fax Number	:	301-774-5823

Provider Business Practice Location Address
First Line	:	3300 OLNEY SANDY SPRING RD
Second Line	:	SUITE 330
City	:	OLNEY
State	:	MD
Zip	:	20832-1494
Country	:	US
Telephone Number	:	301-570-2003
Fax Number	:	301-774-5823

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	07/08/2007

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