Provider Demographics
NPI:1306986062
Name:FERNANDO G CHAVES MD INC
Entity type:Organization
Organization Name:FERNANDO G CHAVES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-856-2107
Mailing Address - Street 1:1421 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6609
Mailing Address - Country:US
Mailing Address - Phone:330-393-5864
Mailing Address - Fax:330-393-9921
Practice Address - Street 1:1421 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6609
Practice Address - Country:US
Practice Address - Phone:330-393-5864
Practice Address - Fax:330-393-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053577207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty