Provider Demographics
NPI:1528038817
Name:ASHBY, CHARLES CHANDLER JR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CHANDLER
Last Name:ASHBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11314
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:111 MEDICAL PKWY FL 2
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0302
Practice Address - Country:US
Practice Address - Phone:757-312-4047
Practice Address - Fax:757-410-0339
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032057207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherMULTIPLAN
VAPAROtherCIGNA
VAPAROtherFIRST HEALTH
VA006034128Medicaid
NC890501FMedicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherAETNA
NC0501FOtherNC BC/BS
VA15792OtherSENTARA OHP/SHP
VA250364OtherANTHEM BC/BS VA HK
VA332291OtherANTHEM BCBS
VAPAROtherVA HEALTHNETWORK/PHCS
VA-001OtherCHAMPUS/TRICARE
VA006023151Medicaid
VA15954OtherOPTIMA/SENTARA
VA263654OtherUNITED HEALTHCARE/MAMSI
VAPAROtherCORVEL/CORCARE
VA263654OtherUNITED HEALTHCARE/MAMSI
NC890501FMedicaid
VAA72308Medicare UPIN
VA060039262Medicare PIN
VA011878C92Medicare PIN