Provider Demographics
NPI:1790752715
Name:WRIGHT, CHRISTOPHER HAROLD (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HAROLD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 NIDER BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23459-8701
Mailing Address - Country:US
Mailing Address - Phone:757-953-8351
Mailing Address - Fax:
Practice Address - Street 1:1035 NIDER BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23459-8701
Practice Address - Country:US
Practice Address - Phone:757-953-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1710I1002XOtherINDEPENDENT DUTY CORPSMEN