Provider Demographics
NPI:1699788190
Name:WALSH, CHRISTOPHER MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:WALSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S SHIRLINGTON RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3618
Mailing Address - Country:US
Mailing Address - Phone:703-717-4245
Mailing Address - Fax:703-717-4248
Practice Address - Street 1:2800 S SHIRLINGTON RD STE 500
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3618
Practice Address - Country:US
Practice Address - Phone:703-717-4245
Practice Address - Fax:703-717-4248
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC014437B28Medicare PIN
I08466Medicare UPIN