Provider Demographics
NPI:1477660314
Name:CONLEY, CHRISTINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:CONLEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-232-8777
Mailing Address - Fax:757-232-8866
Practice Address - Street 1:4844 GEORGE WASHINGTON HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:WHITE MARSH
Practice Address - State:VA
Practice Address - Zip Code:23183-0129
Practice Address - Country:US
Practice Address - Phone:804-693-0042
Practice Address - Fax:804-693-0625
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2012-05-24
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Provider Licenses
StateLicense IDTaxonomies
VT0420009406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1489Medicaid
VTOVN1489Medicaid
VTE12554Medicare UPIN
VA018896T37Medicare PIN