Provider Demographics
NPI:1700175999
Name:CHRISTIAN, DAVID WARE
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WARE
Last Name:CHRISTIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-2531
Mailing Address - Country:US
Mailing Address - Phone:434-392-4165
Mailing Address - Fax:434-392-8554
Practice Address - Street 1:25892 N JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:NEW CANTON
Practice Address - State:VA
Practice Address - Zip Code:23123
Practice Address - Country:US
Practice Address - Phone:434-581-3271
Practice Address - Fax:434-581-2523
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist