Healthcare Provider Details

I. General information

NPI: 1992775381
Provider Name (Legal Business Name): CHRISTOPHER MARK CULP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CENTER 620 JOHN PAUL JONES CIRCLE
PORTSMOUTH VA
23708
US

IV. Provider business mailing address

1005 DOWNSHIRE CHASE
VIRGINIA BEACH VA
23452-6154
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-0679
  • Fax:
Mailing address:
  • Phone: 757-953-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number031230
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: