Healthcare Provider Details

I. General information

NPI: 1548778715
Provider Name (Legal Business Name): CHRISTOPHER RYAN MCGEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 GATOR BLVD
VIRGINIA BEACH VA
23459-8739
US

IV. Provider business mailing address

PSC 851 BOX 930
FPO AE
09834-0010
US

V. Phone/Fax

Practice location:
  • Phone: 678-595-4212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0101267692
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number0101267692
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: