Individual
CHARYSSE JOHNSTON MANOUILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1181 FIRST COLONIAL RD, SUITE 200, VIRGINIA BEACH, VA 23454-2437
(757) 425-1600
(757) 425-6495
Mailing address
1181 FIRST COLONIAL RD, SUITE 200, VIRGINIA BEACH, VA 23454-2437
(757) 425-1600
(757) 425-6495
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101254280
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101254280
LICENSE
VA
Enumeration date
06/29/2009
Last updated
08/06/2021
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