Individual
DR. CHAD M MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5818 HARBOUR VIEW BLVD, STE 240, SUFFOLK, VA 23435
(757) 397-2383
(757) 397-5201
Mailing address
5818 HARBOUR VIEW BLVD, STE 240, SUFFOLK, VA 23435
(757) 397-2383
(757) 397-5201
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
0102201282
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007312393
—
VA
01
—
276458
ANTHEM
VA
01
—
51895
OPTIMA
VA
01
—
770003026
MEDICARE RAILROAD
VA
01
—
89065C3
MEDICAID OF N.C.
NC
Enumeration date
07/11/2005
Last updated
01/15/2018
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