Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 195151 | NY |
NPI | 1306844691 |
---|---|
Provider Name | Michael L Christie |
First Address | Rochester, NY 14605-2131 |
Second Address | Rochester, NY 14605-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 21/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01685285 | (05) | NY |
G19860 | (02) |