Provider Demographics
NPI:1316153737
Name:MCDOWELL, CHRISTINA A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 GODWIN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8151
Mailing Address - Country:US
Mailing Address - Phone:757-983-8750
Mailing Address - Fax:757-510-9442
Practice Address - Street 1:2790 GODWIN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8151
Practice Address - Country:US
Practice Address - Phone:757-983-8750
Practice Address - Fax:757-510-9442
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241762207RC0000X
ND12090207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316153737Medicaid
VA301579OtherANTHEM
VA10021010OtherSENTARA OPTIMA
NC06884OtherBC BS
NC5906884Medicaid
VA2167195OtherUHC/MAMSI
VA301579OtherANTHEM
NC06884OtherBC BS