Provider Demographics
NPI:1992775233
Name:BARRETT, CHRISTINE E (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:E
Last Name:BARRETT
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 1:70 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1505
Mailing Address - Country:US
Mailing Address - Phone:540-483-9017
Mailing Address - Fax:540-483-8872
Practice Address - Street 1:70 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1505
Practice Address - Country:US
Practice Address - Phone:540-483-9017
Practice Address - Fax:540-483-8872
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029905208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007379986Medicaid
VAB08971Medicare UPIN
VA020000091Medicare ID - Type Unspecified