Provider Demographics
NPI:1285604868
Name:PATTON, CHANDLER DEAN (MD)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:DEAN
Last Name:PATTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CORBETT WAY
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2263
Mailing Address - Country:US
Mailing Address - Phone:732-380-0020
Mailing Address - Fax:732-380-1990
Practice Address - Street 1:30 CORBETT WAY
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2263
Practice Address - Country:US
Practice Address - Phone:732-380-0020
Practice Address - Fax:732-380-1990
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50433207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2310805Medicaid
NJ626591BA3Medicare ID - Type Unspecified
NJ2310805Medicaid