Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA06391900 | NJ |
N | 111NI0900X | Internist | 25MA06391900 | NJ |
Y | 207RC0200X | Critical Care Medicine | 25MA06391900 | NJ |
N | 207RP1001X | Pulmonary Disease | 25MA06391900 | NJ |
NPI | 1063497329 |
---|---|
Provider Name | Scott B Chelemer |
First Address | Reston, VA 20190-5359 |
Second Address | Reston, VA 20190-5359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 28/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04911368 | (05) | NY |
102450866-0001 | (05) | PA |
7228805 | (05) | NJ |
E57667 | (02) |