Diedwardo, Christine Anne

Diedwardo, Christine Anne is an individual health care provider with primary practice located at 41 Mall Rd , Burlington MA 01805-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Diedwardo, Christine Anne can be contacted via phone (781) 744-5100.

Contact Information

Primary practice address
41 Mall Rd Burlington MA 01805-0001
Phone: (781) 744-5100
Fax: (781) 744-5215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 204888 Massachusetts

Profile Details

NPI number 1164479705
LBN Legal business name Diedwardo, Christine Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated Oct 29th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164479705 NPPES
Massachusetts MEDICAID 110004228A
Massachusetts MEDICAID 0151246

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