Healthcare Provider Details

I. General information

NPI: 1962197152
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL THOMAS ANDERSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J CLYDE MORRIS BLVD DEPT OF
NEWPORT NEWS VA
23601-1929
US

IV. Provider business mailing address

500 J CLYDE MORRIS BLVD DEPT OF
NEWPORT NEWS VA
23601-1929
US

V. Phone/Fax

Practice location:
  • Phone: 757-612-7200
  • Fax: 757-594-3184
Mailing address:
  • Phone: 757-612-7200
  • Fax: 757-594-3184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102210220
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: