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NPI Code Detail

MEDICARE: MS. CAMILLE MARIE RISTROPH MD

MEDICARE: MS. CAMILLE MARIE RISTROPH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianM-9533ID
2207Q00000XFamily Medicine Physician25517WV

General Provider Information

NPI Number : 1790786028
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAMILLE MARIE RISTROPH MD
Provider Business Mailing Address
First Line : 220 CAMPUS BLVD STE 320
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2889
Country : US
Telephone Number : 540-536-5100
Fax Number : 540-536-0234
Provider Business Practice Location Address
First Line : US HIGHWAY 491 NORTH
Second Line : PHYSICIAN OFFICES
City : SHIPROCK
State : NM
Zip : 87420-0160
Country : US
Telephone Number : 505-368-7010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 09/16/2025

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