Basic Information
| Provider Information | |||||||||
| NPI: | 1568593390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOOD | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11800 SUNRISE VALLEY DR STE 600 | ||||||||
| Address2: | |||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201915327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037091114 | ||||||||
| FaxNumber: | 7037096516 | ||||||||
| Practice Location | |||||||||
| Address1: | 11800 SUNRISE VALLEY DR STE 600 | ||||||||
| Address2: | |||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037091114 | ||||||||
| FaxNumber: | 7037096516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 03/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2007013159 | MO | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | 0101243020 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.