Provider Demographics
NPI:1487188579
Name:MUTCH, CHRISTINA A (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:MUTCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ANTON
Other - Last Name:ARAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2225 S HENRY ST STE U2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3973
Mailing Address - Country:US
Mailing Address - Phone:757-206-2840
Mailing Address - Fax:
Practice Address - Street 1:2225 S HENRY ST STE U2
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3973
Practice Address - Country:US
Practice Address - Phone:757-206-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine