Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101053362 | VA |
NPI | 1013086636 |
---|---|
Provider Name | Christian A. Chisholm |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 02/10/2020 |