Provider Demographics
NPI:1386890614
Name:KILLORAN, CHRISTINA E (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:E
Last Name:KILLORAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 FODEN RD. WEST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2327
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:100 FODEN RD, WEST
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2327
Practice Address - Country:US
Practice Address - Phone:207-523-3900
Practice Address - Fax:207-523-8593
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2011-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME017894207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000837801Medicare PIN