Provider Demographics
NPI:1396768404
Name:CHESSEN, DOUGLAS H (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:CHESSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12420 WARWICK BLVD
Mailing Address - Street 2:7-C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-595-3900
Mailing Address - Fax:757-595-0649
Practice Address - Street 1:860 OMNI BLVD
Practice Address - Street 2:STE 303
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4434
Practice Address - Country:US
Practice Address - Phone:757-232-8769
Practice Address - Fax:757-232-8875
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010238142084A0401X, 2084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7180845Medicaid
VA7180845Medicaid
VA7180845Medicaid