Individual
CHRISTEN CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 GODWIN BLVD, SUITE 3, SUFFOLK, VA 23434-8178
(757) 923-9660
(757) 923-9665
Mailing address
3241 WESTERN BRANCH BLVD, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0116016238
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891985172
—
VA
Enumeration date
08/01/2007
Last updated
04/09/2010
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