Provider Demographics
NPI:1316942964
Name:PRILLAMAN, CHRISTINA W (MD FACP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:W
Last Name:PRILLAMAN
Suffix:
Gender:F
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5900 LAKE WRIGHT DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-1871
Mailing Address - Country:US
Mailing Address - Phone:757-213-5700
Mailing Address - Fax:757-213-5701
Practice Address - Street 1:500 SENTARA CIRCLE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5727
Practice Address - Country:US
Practice Address - Phone:757-229-2236
Practice Address - Fax:757-221-0409
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053122207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA830004889OtherRAILROAD MEDICARE
VA005815363Medicaid
VA12542OtherOPTIMA
830000136Medicare ID - Type Unspecified
VA12542OtherOPTIMA
VA830004889OtherRAILROAD MEDICARE