Provider Demographics
NPI:1104028919
Name:CHASANOV, WILLIAM M II (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:CHASANOV
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:302-644-4830
Practice Address - Street 1:1535 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1611
Practice Address - Country:US
Practice Address - Phone:302-645-3232
Practice Address - Fax:302-645-3198
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2024-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC7-0003773207R00000X
NJ25MB09331000207RI0200X
DEC7-0003733207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine