Provider Demographics
NPI:1528013620
Name:WALSHE, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:WALSHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 CHAMPIONS WAY STE 700
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3763
Mailing Address - Country:US
Mailing Address - Phone:757-686-4655
Mailing Address - Fax:757-686-8099
Practice Address - Street 1:1035 CHAMPIONS WAY STE 700
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3763
Practice Address - Country:US
Practice Address - Phone:757-686-4655
Practice Address - Fax:757-686-8099
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242698207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F43548Medicare UPIN