Individual
CHAD E. MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7758 WALLACE ROAD,, SUITE 6 CERTIFIED PEDIATRICS, IN ASSOC WITH NEMOURS,, ORLANDO, FL 32819-7217
(407) 351-0082
(407) 374-1637
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-4488
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME87612
FL
208D00000X
General Practice Physician
Primary
ME87612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267341000
—
FL
01
—
3240346
AETNA PROVIDER #
FL
01
—
5688069
CIGNA PROVIDER #
FL
01
—
71408
BCBS PROVIDER #
FL
Enumeration date
05/12/2006
Last updated
09/26/2014
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