Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MD16205 | DC |
NPI | 1629167515 |
---|---|
Provider Name | Hollis R. Chaney |
First Address | Washington, DC 20010-2978 |
Second Address | Washington, DC 20010-2978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0300 | CAREFIRST (01) | DC |
6728090 | (05) | VA |
E69353 | (02) |