Provider Demographics
NPI:1205921210
Name:CHRISTIAN, NATHAN (DO)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-3049
Mailing Address - Country:US
Mailing Address - Phone:434-239-8104
Mailing Address - Fax:434-239-4312
Practice Address - Street 1:21556 TIMBERLAKE RD
Practice Address - Street 2:SUITE D
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7234
Practice Address - Country:US
Practice Address - Phone:434-239-8104
Practice Address - Fax:434-239-4312
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102033534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA197594OtherANTHEM
VA197594OtherANTHEM