Provider Demographics
NPI:1568763159
Name:VIS, CHRISTOPHER ANTHONY (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:VIS
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4280 SINGAPORE PL
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20189-4279
Mailing Address - Country:US
Mailing Address - Phone:571-517-4057
Mailing Address - Fax:
Practice Address - Street 1:2401 E ST NW SA-1 COLUMBIA PLAZA SUITE L 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0102
Practice Address - Country:US
Practice Address - Phone:202-663-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2025-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-05081363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant