Provider Demographics
NPI:1932455797
Name:CHRISTOPHER DOWD DO PC
Entity Type:Organization
Organization Name:CHRISTOPHER DOWD DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DOWD,
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:757-337-4018
Mailing Address - Street 1:1024 CENTERBROOKE LN
Mailing Address - Street 2:SUITE F, PMB 412
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8291
Mailing Address - Country:US
Mailing Address - Phone:757-337-4018
Mailing Address - Fax:757-337-4019
Practice Address - Street 1:5849 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3768
Practice Address - Country:US
Practice Address - Phone:757-337-4018
Practice Address - Fax:757-337-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201644207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI35335Medicare UPIN