Healthcare Provider Details

I. General information

NPI: 1154900231
Provider Name (Legal Business Name): CHRISTINA MCCORMICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SENTARA CIR STE 202
WILLIAMSBURG VA
23188-5727
US

IV. Provider business mailing address

500 SENTARA CIR STE 202
WILLIAMSBURG VA
23188-5727
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-9850
  • Fax: 757-345-6643
Mailing address:
  • Phone: 757-984-9850
  • Fax: 757-345-6643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101289652
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: