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Individual

MONICA DANIELLE CHETELAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-9845
Mailing address
34 E HAMBURG ST, BALTIMORE, MD 21230-4034
(410) 746-2458

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1075400
MD
363AS0400X
Surgical Physician Assistant
1075400
MD

Other

Enumeration date
10/09/2007
Last updated
10/09/2007
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