# CHICKAHOMINY FAMILY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043217912
- **Authorized official:** K MICHELLE CHRISTIAN (OFFICE MANAGER)
- **Authorized official phone:** (804) 932-4388

## Contact information

- **Practice address:** 2500 NEW KENT HWY, QUINTON, VA 23141-1735
- **Practice address phone:** (804) 932-4388
- **Practice address fax:** (804) 932-9860
- **Mailing address:** PO BOX 7, QUINTON, VA 23141-0007
- **Mailing address phone:** (804) 932-4388
- **Mailing address fax:** (804) 932-9860

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | VA | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 057298 | BCBS | VA |
| 01 | — | 065167 | BCBS | VA |
| 05 | — | 5622557 | — | VA |