Provider Demographics
NPI:1528033438
Name:MATSON, CHRISTINE C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:C
Last Name:MATSON
Suffix:
Gender:F
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5955
Mailing Address - Fax:757-446-5196
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:118
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-446-5196
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2180432OtherUHC MAMSI
VAPAROtherVIRGINIA HEALTH NETWORK
NC890666TMedicaid
VA-002 -003OtherTRICARE/CHAMPUS
NC0666TOtherBC/BS
VAPAROtherCORVEL/CORCARE
VAPAROtherVIRGINIA PREMIER HEALTH
VA005611920Medicaid
VA005612586Medicaid
VA058159OtherANTHEM
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VA11061OtherSENTARA OPTIMA
VAPAROtherCIGNA
NC890666TMedicaid
VA080050890Medicare PIN
VA-002 -003OtherTRICARE/CHAMPUS