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General NPI Number Information
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NPI Number | 1568763159
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Entity Type | Individual
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Provider Name | CHRISTOPHER ANTHONY VIS PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2401 E ST NW SA-1 COLUMBIA PLAZA SUITE L 201
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City | WASHINGTON
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State | DC
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Zip | 20522-0102
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Country | US
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Telephone | 202-663-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 4280 SINGAPORE PL
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City | DULLES
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State | VA
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Zip | 20189-4279
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Country | US
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Telephone | 571-517-4057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-05081
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License Number State | NC
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