Healthcare Provider Details

I. General information

NPI: 1235940479
Provider Name (Legal Business Name): MR. CHRISTOPHER EUGENE BIDDIX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20550 WARRIORS WAY
MILFORD VA
22514
US

IV. Provider business mailing address

7116 JOHN MARSHALL MEWS
RUTHER GLEN VA
22546-5811
US

V. Phone/Fax

Practice location:
  • Phone: 804-529-3486
  • Fax:
Mailing address:
  • Phone: 717-747-6619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704016900
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: