Provider Demographics
NPI:1063699577
Name:CHACHICH, DANIEL BRIAN (RN)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:CHACHICH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORTH GREEN STREET
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-605-7237
Mailing Address - Fax:410-605-7919
Practice Address - Street 1:10 NORTH GREENE STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-605-7237
Practice Address - Fax:410-605-7919
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR077916163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse