Provider Demographics
NPI:1285795856
Name:CHAVIS, CYRIL VERNON (MD)
Entity type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:VERNON
Last Name:CHAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4028 CHURCH POINT RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-7038
Mailing Address - Country:US
Mailing Address - Phone:757-363-6061
Mailing Address - Fax:757-363-9575
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-1194
Practice Address - Fax:757-953-0805
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101223026171000000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology