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Organization
PAUL D CHIDESTER MD ET AL
Active
Organization
PAUL D CHIDESTER MD ET AL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL D CHIDESTER MD (OWNER)
(757) 436-6959
Entity
Organization
Contact information
Practice address
300 MEDICAL PKWY, SUITE 306, CHESAPEAKE, VA 23320-4985
(757) 410-8791
(757) 410-8783
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15097
SENTARA OPTIMA
VA
01
—
194475
ANTHEM
VA
01
—
319574
MDIPA
VA
01
—
7660794
AETNA
VA
Enumeration date
07/22/2006
Last updated
08/22/2020
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