Basic Information
| Provider Information | |||||||||
| NPI: | 1306815071 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COREY | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PEARL STREET | ||||||||
| Address2: | SUITE 2700 | ||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023012870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085844104 | ||||||||
| FaxNumber: | 5085844105 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 PEARL STREET | ||||||||
| Address2: | SUITE 2700 | ||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023012870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085844104 | ||||||||
| FaxNumber: | 5085844105 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 46141 | MA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 17-00354 | 01 | MA | UNITED HEALTHCARE | OTHER | COB33626 | 01 | MA | BC/BS PROVIDER # | OTHER | NP0073470 | 01 | MA | HEALTHNET | OTHER | 0013816 | 01 | MA | NEIGHBORHOOD HEALTH | OTHER | 46141 | 01 | MA | TUFTS PROVIDER # | OTHER | 8032 | 01 | MA | HARVARD PILGRIM PROVIDER | OTHER | P00092431 | 01 | MA | RAILROAD MEDICARE | OTHER | 136905 | 05 | MA | MEDICAID | 92799 | 01 | MA | AETNA PROVIDER # | OTHER |