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Individual

MICHAEL KIRK CHASTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(678) 216-0771
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
(678) 854-9235

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN252524
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041040400
DC
05
1225461973
VA
05
422329200
MD
Enumeration date
08/16/2013
Last updated
12/06/2022
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