Provider Demographics
NPI:1700881109
Name:HIGGINS, CHRISTINE D (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 GAINSBOROUGH SQ
Mailing Address - Street 2:STE 300
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1714
Mailing Address - Country:US
Mailing Address - Phone:757-547-9286
Mailing Address - Fax:757-547-5692
Practice Address - Street 1:113 GAINSBOROUGH SQ
Practice Address - Street 2:STE 300
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1714
Practice Address - Country:US
Practice Address - Phone:757-547-9286
Practice Address - Fax:757-547-5692
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054379207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005875111Medicaid
H59357Medicare UPIN
VA110008377Medicare ID - Type Unspecified