Christie, Donovan Wayne
Christie, Donovan Wayne is an sole proprietor health care provider with primary practice located at 2227 Idlewood Rd , Tucker GA 30084-4827. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Christie, Donovan Wayne can be contacted via phone (678) 205-2039.Contact Information
Primary practice address
2227 Idlewood Rd
Tucker GA 30084-4827
Phone: (678) 205-2039
Fax: (678) 205-2040
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 044432 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 044432 | Georgia |
Profile Details
| NPI number | 1831157072 |
|---|---|
| LBN Legal business name | Christie, Donovan Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | Mar 17th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831157072 | NPPES |
| Georgia | MEDICAID | 00845798K | |
| Georgia | MEDICAID | 000845798H | |
| Georgia | MEDICAID | 000845798P |
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