Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 01042615 | IN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 01042615 | IN |
NPI | 1982770285 |
---|---|
Provider Name | Dr. Dion Debro Chavis |
First Address | Indianapolis, IN 46260-5381 |
Second Address | Indianapolis, IN 46260-5349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 16/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100384300A | (05) | IN |