Provider Demographics
NPI:1821427535
Name:CENTRAL VIRGINIA PERINATOLOGY
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA PERINATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HATJIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-741-3260
Mailing Address - Street 1:1300 HOSPITAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8451
Mailing Address - Country:US
Mailing Address - Phone:540-741-3260
Mailing Address - Fax:540-741-3261
Practice Address - Street 1:1300 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8451
Practice Address - Country:US
Practice Address - Phone:540-741-3260
Practice Address - Fax:540-741-3261
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY WASHINGTON HEALCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169807363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty