Individual
CHRISTINA M IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1240 LEE ST, CHARLOTTESVILLE, VA 22908-2350
(434) 924-9333
(434) 244-7526
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
0110003111
VA
363AM0700X
Medical Physician Assistant
Primary
0110003111
VA
Other
Enumeration date
04/25/2008
Last updated
09/25/2024
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