Individual
DR. CHRISTINE CREELY DORVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4810 N DAVIS HWY, PENSACOLA, FL 32503-2341
(850) 474-8988
(850) 476-5312
Mailing address
4828 N DAVIS HWY, PENSACOLA, FL 32503-2341
(850) 477-8109
(850) 478-2412
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
ME90033
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME90033
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018598200
—
FL
01
—
46177
BCBS
FL
01
—
46177A
MCR
FL
01
—
592-10656
BCBS
AL
Enumeration date
03/02/2006
Last updated
04/13/2018
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