Provider Demographics
NPI:1992748719
Name:CHRISTIE, DANIEL ROSS (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROSS
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 N STATE ROAD 7
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5755
Mailing Address - Country:US
Mailing Address - Phone:954-247-6200
Mailing Address - Fax:
Practice Address - Street 1:2960 N STATE ROAD 7
Practice Address - Street 2:SUITE 300
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5755
Practice Address - Country:US
Practice Address - Phone:954-247-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26562207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009931834Medicaid
AL051529332OtherBLUE CROSS
ALI33227OtherVIVA
AL009931833Medicaid
AL051529333OtherBLUE CROSS
AL009931833Medicaid