Individual
JOY CRUZ CHESNUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
210 N 7TH ST STE 101, MARIETTA, OH 45750-2244
(740) 376-0490
(740) 376-0438
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20586
WV
207Q00000X
Family Medicine Physician
20586
WV
207Q00000X
Family Medicine Physician
Primary
35.121478
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812506000
—
WV
05
—
2342290
—
OH
01
—
P00072644
RAILROAD MEDICARE
—
01
—
P00744174
RAILROAD MEDICARE
WV
01
—
P01414936
RAILROAD MEDICARE PTAN - MHCPI
OH
Enumeration date
03/09/2006
Last updated
07/21/2022
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