Provider Demographics
NPI:1528305778
Name:CHAMBERS MEDICAL GROUP
Entity type:Organization
Organization Name:CHAMBERS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, MPH
Authorized Official - Phone:813-661-4268
Mailing Address - Street 1:1052 E BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5509
Mailing Address - Country:US
Mailing Address - Phone:813-266-1426
Mailing Address - Fax:813-661-5514
Practice Address - Street 1:5108 15TH ST E
Practice Address - Street 2:SUITE 205
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4886
Practice Address - Country:US
Practice Address - Phone:941-727-9057
Practice Address - Fax:941-727-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41187174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty