Provider Demographics
NPI:1699700096
Name:DOUGLAS H CHESSEN MD PC
Entity type:Organization
Organization Name:DOUGLAS H CHESSEN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-595-3900
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 1:12420 WARWICK BLVD
Practice Address - Street 2:7-C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-595-3900
Practice Address - Fax:757-595-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
VA009-02-001324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Not Answered324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty