Provider Demographics
NPI:1629009543
Name:MASTROYANNIS, CHRISTOS (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOS
Middle Name:
Last Name:MASTROYANNIS
Suffix:
Gender:M
Credentials:MD FACOG
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 61306
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23466-1306
Mailing Address - Country:US
Mailing Address - Phone:877-449-0400
Mailing Address - Fax:866-696-6573
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:STE 500
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4617
Practice Address - Country:US
Practice Address - Phone:877-449-0400
Practice Address - Fax:866-696-6573
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101045024207VE0102X
DCMD16241207VE0102X
MDD0030967207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAJ5120002OtherCAREFIRST
VA3137110OtherALLIANCE
VA058066OtherANTHEM BCBS
VA0721945OtherCIGNA
VA238730OtherANTHEM
VA4137457OtherAETNA
VA058066OtherANTHEM BCBS
VA507349Medicare ID - Type Unspecified