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General NPI Number Information
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NPI Number | 1972248920
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL MADDOX MED, PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 3959 ELECTRIC RD
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City | ROANOKE
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State | VA
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Zip | 24018-4562
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Country | US
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Telephone | 540-339-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 16 OLD WHITMORE AVE SE APT 521
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City | ROANOKE
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State | VA
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Zip | 24016-1237
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Country | US
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Telephone | 443-802-0786
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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