Provider Demographics
NPI:1063408086
Name:DENISON, CHRISTINE M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:DENISON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-6269
Mailing Address - Fax:617-264-5151
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-6269
Practice Address - Fax:617-264-5151
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2012-08-08
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Provider Licenses
StateLicense IDTaxonomies
MA740562085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3095291Medicaid
MAJ11708OtherBLUE CROSS BLUE SHIELD
MA739930OtherTUFTS HEALTH CARE
MAAA7347OtherHARVARD PILGRIM
MAF03499Medicare UPIN
MAAA7347OtherHARVARD PILGRIM