Healthcare Provider Details

I. General information

NPI: 1851528558
Provider Name (Legal Business Name): CHRISTINE ROSE JAMES D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE R JAMES DO

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 EDWIN DR STE 208
CHESAPEAKE VA
23322-6531
US

IV. Provider business mailing address

1933 EDWIN DR STE 208
CHESAPEAKE VA
23322-6531
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-5820
  • Fax:
Mailing address:
  • Phone: 757-252-5820
  • Fax: 757-963-9609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2023-01995
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number006217
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0102207863
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: