Healthcare Provider Details

I. General information

NPI: 1548639503
Provider Name (Legal Business Name): CHRISTOPHER STEVEN BARBER IDC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GATOR BLVD BLDG 3808
VIRGINIA BEACH VA
23459-8950
US

IV. Provider business mailing address

26 MALLARD DR.
GROTON CT
06340
US

V. Phone/Fax

Practice location:
  • Phone: 760-521-0371
  • Fax:
Mailing address:
  • Phone: 760-521-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: