Organization
ISC PORTSMOUTH HEALTH SERVICES DIVISION USCG
Active
Other names
ISC Portsmouth Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J CRISTY DDS (CHIEF, HEALTH SERVICES DIVISION)
(757) 483-8686
Entity
Organization
Contact information
Practice address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2199
(757) 483-8597
(757) 483-8610
Mailing address
4000 COAST GUARD BLVD, PORTSMOUTH, VA 23703-2199
(757) 483-8597
(757) 483-8610
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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