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Individual

CHRISTOPHER P LAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8200 MEADOWBRIDGE RD STE 200, MECHANICSVILLE, VA 23116
(804) 730-2121
Mailing address
1115 BOULDERS PKWY STE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018-01738
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0101266188
VA

Other

Enumeration date
05/06/2015
Last updated
09/03/2020
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