Provider Demographics
NPI:1821161183
Name:NORTHRUP, CHRISTINE DEE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:DEE
Last Name:NORTHRUP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:368 DORSET ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6236
Mailing Address - Country:US
Mailing Address - Phone:802-860-1441
Mailing Address - Fax:802-860-4324
Practice Address - Street 1:368 DORSET ST
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6236
Practice Address - Country:US
Practice Address - Phone:802-860-1441
Practice Address - Fax:802-860-4324
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420009310207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4661801OtherFLETCHER ALLEN HEALTH CAR
VTOVN1442Medicaid
VT11128895OtherBCBS
VT11128895OtherBCBS
VT4661801OtherFLETCHER ALLEN HEALTH CAR